Healthcare Provider Details

I. General information

NPI: 1609707512
Provider Name (Legal Business Name): RACHEL REKA BRADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 S NEBRASKA ST
SALEM SD
57058-8917
US

IV. Provider business mailing address

511 S MICKELSON AVE
VERMILLION SD
57069-3476
US

V. Phone/Fax

Practice location:
  • Phone: 605-425-3303
  • Fax:
Mailing address:
  • Phone: 605-670-1682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6268
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: