Individual
BRANDT GRUIZINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-2000
Mailing address
810 CHEYENNE ST, GOLDEN, CO 80401-1037
(616) 502-9581
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
NA
—
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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