NPI 1174964761

Leslie John Mitkos, ATC

Practitioner Athletic Trainer Camp Lejeune, NC

Practice location

Address: 100 Brewster Blvd, Camp Lejeune, NC 28547-2575
Phone: (910) 449-0324
Mailing address: 619 Castine Way, Wilmington, NC 28412-2763

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 096.002508 (IL)

Other Specialist/Technologist providers in North Carolina →

Registry record

NPI: 1174964761
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jul 2013
Record last updated: 21 Mar 2017

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.