Provider Demographics
NPI:1982844007
Name:HEIDBRAK, BONNIE (CCH, RSHOM (NA))
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:HEIDBRAK
Suffix:
Gender:F
Credentials:CCH, RSHOM (NA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 EVENING STAR LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9364
Mailing Address - Country:US
Mailing Address - Phone:720-200-4403
Mailing Address - Fax:
Practice Address - Street 1:2239 EVENING STAR LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-9364
Practice Address - Country:US
Practice Address - Phone:720-200-4403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath