Healthcare Provider Details

I. General information

NPI: 1790658771
Provider Name (Legal Business Name): BROOKE EURTON-HENDERSON ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 JUNCTION RD STE C
MADISON WI
53717-2151
US

IV. Provider business mailing address

3873 E OLD PINE TRL
MIDLAND MI
48642-8864
US

V. Phone/Fax

Practice location:
  • Phone: 608-467-8116
  • Fax:
Mailing address:
  • Phone: 909-436-9792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number6080-170
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: