Individual
MAXINE WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(973) 459-9937
Mailing address
3301 ROYSTER LN APT 901, CLARKSVILLE, TN 37042-7744
(973) 459-9937
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007088
PA
Other
Enumeration date
11/28/2017
Last updated
09/13/2023
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