Provider Demographics
NPI:1952637720
Name:BERTELSON, BROOKE LINDSEY (ND)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:LINDSEY
Last Name:BERTELSON
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 1:3126 TURNBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-9474
Mailing Address - Country:US
Mailing Address - Phone:406-698-5373
Mailing Address - Fax:
Practice Address - Street 1:9340 S FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6100
Practice Address - Country:US
Practice Address - Phone:406-656-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT121175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath