Individual
JULIA PANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT, PES
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 451-7529
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 451-7529
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
25MT00152100
NJ
2255A2300X
Athletic Trainer
AT002402
GA
2255A2300X
Athletic Trainer
Primary
RTO000069
PA
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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