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Individual

KENNETH JOSEPH KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT

Contact information

Practice address
23203 BULVERDE RD, SAN ANTONIO, TX 78259-2203
(210) 356-0400
Mailing address
8976 SCARLET CRK, UNIVERSAL CITY, TX 78148-3785
(210) 445-7489

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3935
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3935
ATHLETIC TRAINER
TX
Enumeration date
03/02/2021
Last updated
03/02/2021
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