Individual
KIRK A RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, NASM-CES
Contact information
Practice address
201 JORDANVILLE RD, AYNOR, SC 29511-3601
(843) 488-7109
Mailing address
171 PINE FOREST DRIVE, CONWAY, SC 29526-5981
(419) 792-9412
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000036934
SC
Other
Enumeration date
03/04/2021
Last updated
08/28/2024
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