Individual
BRIAN HEIDVOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 S 42ND ST, OMAHA, NE 68105-2909
(402) 553-3000
Mailing address
1720 N 51ST ST, OMAHA, NE 68104-5011
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5182
NE
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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