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1831717073
MARIBETH ROSE BOEKE GANZELL
ST MARYS CITY, MD
NPI
1831717073
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: MD A00247)
Enumeration Date
2020-07-13
Last Update Date
2020-07-13
Business Address
MARIBETH ROSE BOEKE GANZELL LAT, ATC
18952 E FISHER RD
ST MARYS CITY, MD 20686-3001
Phone number: 909-241-2853
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Mailing Address
MARIBETH ROSE BOEKE GANZELL LAT, ATC
48836 PARK PINES DR
LEXINGTON PARK, MD 20653-3515
Phone number: 909-241-2853
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