Healthcare Provider Details

I. General information

NPI: 1720299472
Provider Name (Legal Business Name): DANIEL P BRADY PA-C, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 02/13/2024
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E LIBERTY ST STE 600
RENO NV
89501-2110
US

IV. Provider business mailing address

550 W PLUMB LN # 185
RENO NV
89509-3468
US

V. Phone/Fax

Practice location:
  • Phone: 775-636-6200
  • Fax: 775-249-0010
Mailing address:
  • Phone: 775-636-6200
  • Fax: 775-249-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberA-31007
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1576
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01391
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: