NPI 1104315050

Mitchell Edward Mleziva

Practitioner Athletic Trainer Mequon, WI

Practice location

Address: 12800 N Lake Shore Dr, Mequon, WI 53097-2418
Phone: (262) 243-4414
Mailing address: 509 Hillcrest CT, Saukville, WI 53080-2560

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 1720-39 (WI)

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1104315050
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 May 2018
Record last updated: 7 May 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.