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Contact Information

SHELBY N KENISON, ATC
28675 740TH AVE
CLARKS GROVE, MN56016-4041
 Phone: 507-213-3487
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for SHELBY N KENISON · (Female)

NPI # 1790020949
Status Active
Credentials ATC
Entity Individual
Enumeration date 11/29/2012
Last updated 03/11/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 2306
  • MN Other 1790020949 NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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