Provider Demographics
NPI:1093014946
Name:STEWART, BRETT MAKANI (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:MAKANI
Last Name:STEWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 N TREKELL RD
Mailing Address - Street 2:101
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-2832
Mailing Address - Country:US
Mailing Address - Phone:520-705-2987
Mailing Address - Fax:
Practice Address - Street 1:1415 N TREKELL RD
Practice Address - Street 2:101
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2832
Practice Address - Country:US
Practice Address - Phone:520-705-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor