Brandt Gruizinga
Student in an Organized Health Care Education/Training Program in Chicago, IL. Individual provider (NPI-1).
NPI number1457081978
StatusActive
Last updated in NPPESJun 16, 2022
Details
- NPI
- 1457081978
- Entity type
- Individual (NPI-1)
- Name
- Brandt Gruizinga
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2022
- Certification date
- Jun 16, 2022
- Last updated
- Jun 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | NA | – | Yes |
Practice location
251 E Huron StChicago, IL 60611-2908
Phone 312-926-2000
Mailing address
810 Cheyenne StGolden, CO 80401-1037
Phone 616-502-9581
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