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Individual

BRIAN PHILIP NIEBUHR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4160 JOHN R ST STE 615, DETROIT, MI 48201-2022
(313) 993-8669
Mailing address
4119 AVERY PASS, FORT WAYNE, IN 46845-9183
(260) 615-3626

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
04/17/2023
Last updated
04/17/2023
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