Provider Demographics
NPI:1780196675
Name:SHENKMAN, BRETT F (NMD, ND)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:F
Last Name:SHENKMAN
Suffix:
Gender:M
Credentials:NMD, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 NAVAHOPI RD APT B
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4165
Mailing Address - Country:US
Mailing Address - Phone:610-730-4864
Mailing Address - Fax:
Practice Address - Street 1:125 KALLOF PL
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5566
Practice Address - Country:US
Practice Address - Phone:928-239-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4115175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath