Healthcare Provider Details

I. General information

NPI: 1760131130
Provider Name (Legal Business Name): BRADY JAMES JOHNSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16944 W BELL RD STE 602
SURPRISE AZ
85374-8950
US

IV. Provider business mailing address

16944 W BELL RD STE 602
SURPRISE AZ
85374-8950
US

V. Phone/Fax

Practice location:
  • Phone: 623-505-7226
  • Fax:
Mailing address:
  • Phone: 623-505-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: