Provider Demographics
NPI:1003880758
Name:LETO, MARK C (ATC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:C
Last Name:LETO
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-3574
Mailing Address - Country:US
Mailing Address - Phone:219-947-7829
Mailing Address - Fax:
Practice Address - Street 1:36 E 8TH ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-5144
Practice Address - Country:US
Practice Address - Phone:219-942-3100
Practice Address - Fax:219-942-5983
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000014A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer