Individual
BRENT HEIMLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 FRUIT ST., WHITE 1, BOSTON, MA 02114-2696
(617) 724-4100
(617) 726-7415
Mailing address
19 E SPRINGFIELD ST APT 1, BOSTON, MA 02118-3362
(917) 687-2451
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
11/23/2021
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