National Provider Identifier

Maddie Boerman

Maddie Boerman is listed in the NPPES registry with a primary specialty of Athletic Trainer in Lansing, NY and a listed phone number of (607) 222-8315.

NPI 1770116162Lansing, NYAthletic Trainer

Profile Overview

NPI
1770116162
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
February 13, 2020
Last Updated
February 13, 2020

Practice Location

  • 81 Wilson RD
  • Lansing, NY 14882-9017

Phone: (607) 222-8315

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1770116162
Entity Type
Individual
Last Name
Boerman
First Name
Maddie
Mailing Street Address
81 Wilson RD
Mailing City
Lansing
Mailing State
NY
Mailing ZIP Code
14882-9017
Mailing Country
US
Practice Street Address
81 Wilson RD
Practice City
Lansing
Practice State
NY
Practice ZIP Code
14882-9017
Practice Country
US
Practice Phone
(607) 222-8315
Enumeration Date
February 13, 2020
Last Updated
February 13, 2020
Sex
Female
Sole Proprietor
No
Certification Date
February 13, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)