Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 1215 | NE |
NPI | 1114942406 |
---|---|
Provider Name | Dr. Gregory D Hoogeveen |
First Address | Bellevue, NE 68005-2940 |
Second Address | Bellevue, NE 68005-2940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
42123210000 | (05) | NE |
OTH000 | (02) | NE |