Healthcare Provider Details

I. General information

NPI: 1881539666
Provider Name (Legal Business Name): BROOKE ASHTON CASTILLO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 W MAIN ST
FREMONT MI
49412-1484
US

IV. Provider business mailing address

307 MAPLEBROOKE LN
CADILLAC MI
49601-8763
US

V. Phone/Fax

Practice location:
  • Phone: 231-924-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901005978
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: