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Individual

MAISIE BOEHM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT

Contact information

Practice address
700 GENEVA PKWY N, LAKE GENEVA, WI 53147-4594
(262) 249-3529
(262) 249-7955
Mailing address
700 GENEVA PKWY N, LAKE GENEVA, WI 53147-4594
(262) 249-3529
(262) 249-7955

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
03/25/2020
Last updated
03/25/2020
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