Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maribeth Rose Boeke Ganzell, LAT, ATC

Individual provider Athletic Trainer · NPI 1831717073

Maribeth Rose Boeke Ganzell, LAT, ATC is an Athletic Trainer in St Marys City, Maryland. Licensed in Maryland. Registered with an NPI since 2020.

Licensed in
MD
In the registry since
2020
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

18952 E Fisher Rd
St Marys City, MD 20686-3001
Phone: (909) 241-2853
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence A00247 (MD)

Record details

NPI number1831717073
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedJuly 13, 2020
Last updated in NPPESJuly 13, 2020
Certification dateJuly 13, 2020

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