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General NPI Number Information
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NPI Number | 1053712166
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Entity Type | Individual
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Provider Name | BRADY POWELL PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 2225 CIVIC CENTER DR STE 100
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-6328
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Country | US
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Telephone | 702-586-5778
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Fax | 702-586-5758
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Provider Business Mailing Address
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Address Line | 2225 CIVIC CENTER DR STE 100
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-6328
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Country | US
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Telephone | 702-586-5778
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Fax | 702-586-5758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1207843
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 3099
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 3099
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3099
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License Number State | NV
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