Individual
JULIE A MISTOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1007 PORTERS NECK RD, WILMINGTON, NC 28411-7383
(910) 686-6506
Mailing address
4144 HEARTHSIDE DR, APT. 201, WILMINGTON, NC 28412-8512
(330) 518-5975
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3768
NC
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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