Provider Demographics
NPI:1770053340
Name:RATTANAPON, ARISMUN BOBBY (LAT, ATC)
Entity type:Individual
Prefix:
First Name:ARISMUN
Middle Name:BOBBY
Last Name:RATTANAPON
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W WESTHOFF PL
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030
Mailing Address - Country:US
Mailing Address - Phone:913-485-2878
Mailing Address - Fax:
Practice Address - Street 1:1610 N 8TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2099
Practice Address - Country:US
Practice Address - Phone:913-627-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-014272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer