Individual
DR. LES DUTKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D., LAT, ATC
Contact information
Practice address
222 E OAK RIDGE DR, SUITE 1800, HAGERSTOWN, MD 21740-7858
(301) 739-0090
(301) 739-0288
Mailing address
103 NOAHS CT, MARTINSBURG, WV 25404-5459
(304) 263-1479
(301) 797-7066
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126000603
LICSENED ATHLETIC TRAINER
VA
Enumeration date
08/15/2005
Last updated
07/31/2009
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