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1184387938
MOLLY ANN VANDERBOOM
ROCHESTER, MN
NPI
1184387938
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 2668)
Enumeration Date
2021-10-19
Last Update Date
2021-10-19
Business Address
MOLLY ANN VANDERBOOM M.Ed., ATC, LAT, OPE
5155 55TH ST NW
ROCHESTER, MN 55901-3855
Phone number: 507-292-7174
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Mailing Address
MOLLY ANN VANDERBOOM M.Ed., ATC, LAT, OPE
1001 EAGLE VISTA LN
LAKE CITY, MN 55041-4413
Phone number: 319-360-8286
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