Individual
MARIBETH ROSE BOEKE GANZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
18952 E FISHER RD, ST MARYS CITY, MD 20686-3001
(909) 241-2853
Mailing address
48836 PARK PINES DR, LEXINGTON PARK, MD 20653-3515
(909) 241-2853
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A00247
MD
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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