Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mitchell Lee Anderson

Individual provider Athletic Trainer · NPI 1134647407

Mitchell Lee Anderson is an Athletic Trainer in Fort Wayne, Indiana. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

3946 Ice Way
Fort Wayne, IN 46805-1018
Phone: (319) 693-9912
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1134647407
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 6, 2017
Last updated in NPPESDecember 5, 2024
Certification dateDecember 4, 2024
Mailing address3946 Ice Way, Fort Wayne, IN 46805-1018

Other providers in Fort Wayne