Provider Demographics
NPI:1861903973
Name:WOJCIAK, BRET BARTHOLOMEW (NMD)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:BARTHOLOMEW
Last Name:WOJCIAK
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 S PLAZA WAY STE 150
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7156
Mailing Address - Country:US
Mailing Address - Phone:928-226-1556
Mailing Address - Fax:
Practice Address - Street 1:1585 S PLAZA WAY STE 150
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7156
Practice Address - Country:US
Practice Address - Phone:928-226-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17-1671175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath