Provider Demographics
NPI:1790658771
Name:EURTON-HENDERSON, BROOKE (ND)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:EURTON-HENDERSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3873 E OLD PINE TRL
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8864
Mailing Address - Country:US
Mailing Address - Phone:909-436-9792
Mailing Address - Fax:
Practice Address - Street 1:515 JUNCTION RD STE C
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2151
Practice Address - Country:US
Practice Address - Phone:608-467-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6080-170175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath