Eric M. Ahonen, ATC

Individual provider Active NPI Athletic Trainer · Kenosha, WI

NPI 1366769754 · NPPES record last updated Apr 28, 2010

Key facts

NPI
1366769754
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1062-39 (WI)
Practice address
3915 30TH Ave
Kenosha, WI 53144-1957
Phone
(224) 717-6666
Fax
(262) 657-7190
NPI assigned
Apr 26, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1062-39WIMDAthletic Trainer

Interoperability endpoints

  • Direct secure messaging: eric.ahonen.p4@direct.athleticoltd.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1062-39 WI Yes

Addresses

Primary practice location

3915 30TH Ave
Kenosha, WI 53144-1957

Mailing address

3915 30TH Ave
Kenosha, WI 53144-1957
Phone (224) 717-6666

Other providers in Kenosha, WI

All providers in Kenosha, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.