Provider Demographics
NPI:1730720525
Name:BRANDT, AUSTIN PAUL (ND)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:PAUL
Last Name:BRANDT
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24952 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487
Mailing Address - Country:US
Mailing Address - Phone:541-554-1282
Mailing Address - Fax:541-566-8129
Practice Address - Street 1:24952 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487
Practice Address - Country:US
Practice Address - Phone:541-554-1282
Practice Address - Fax:541-566-8129
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath