Provider Demographics
NPI:1659792455
Name:WHONSETLER, KYLE (AT,ATC, MAT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:WHONSETLER
Suffix:
Gender:M
Credentials:AT,ATC, MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 N. MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865
Mailing Address - Country:US
Mailing Address - Phone:419-628-6920
Mailing Address - Fax:
Practice Address - Street 1:326 N. MAIN ST
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865
Practice Address - Country:US
Practice Address - Phone:419-628-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0042802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer