Provider Demographics
NPI:1972531994
Name:KESSLER, DONALD FREDRICK (ATC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:FREDRICK
Last Name:KESSLER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6436 LAKE MERE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119
Mailing Address - Country:US
Mailing Address - Phone:619-890-7543
Mailing Address - Fax:619-594-7654
Practice Address - Street 1:5500 CAMPANILLE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92182-4313
Practice Address - Country:US
Practice Address - Phone:619-594-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000023002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer