Individual
MR. JOHN MITROVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT SCS ATC CSCS
Contact information
Practice address
4125 IRONBOUND RD STE 100, WILLIAMSBURG, VA 23188-2666
(757) 220-8383
(757) 253-7833
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003424
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192935
BCBS PHYSICAL THERAPY
VA
01
—
4460951
AETNA
—
01
—
650003973
RAILROAD MEDICARE
VA
05
—
8928649
—
VA
Enumeration date
04/11/2006
Last updated
04/27/2018
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