Individual
BENJAMIN HEINZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2820 HPER CTR, BROOKINGS, SD 57007-0001
(605) 688-4003
Mailing address
1417 SHERIDAN CIR, BROOKINGS, SD 57006-5479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0118
SD
Other
Enumeration date
04/04/2006
Last updated
07/10/2015
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