NPI 1831717073

Maribeth Rose Boeke Ganzell, LATATC

Practitioner Athletic Trainer St Marys City, MD

Practice location

Address: 18952 E Fisher Rd, St Marys City, MD 20686-3001
Phone: (909) 241-2853
Mailing address: 48836 Park Pines Dr, Lexington Park, MD 20653-3515

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence A00247 (MD)

Other Specialist/Technologist providers in Maryland →

Registry record

NPI: 1831717073
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jul 2020
Record last updated: 13 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.