Individual
MIGUEL MAXIMILIAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
9 HOPE AVE, WALTHAM, MA 02453-2741
(781) 216-3715
Mailing address
69 FULLER ST APT 2, WALTHAM, MA 02453-5840
(860) 921-7808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATL2471
MA
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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