IndividualActive
Shelby Kenison, ATC
NPI 1790020949 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Clarks Grove, MN
Provider details
- NPI number
- 1790020949
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- License
- 2306 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
28675 740th Ave
Clarks Grove, MN 56016-4041
Phone: (507) 213-3487
Approximate (ZIP-level) locationGet directions
Mailing address
28675 740th Ave
Clarks Grove, MN 56016-4041
Additional practice locations (1)
- 103 Independence Ave SClarks Grove, MN 56016-7704Phone: (507) 213-3487
Registry dates
- Enumerated
- 2012-11-29
- Last updated
- 2020-03-11
- Certified
- 2020-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.