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General NPI Number Information
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NPI Number | 1487965505
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Entity Type | Organization
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Legal Business Name | SCOTT BRADY, D.C., LTD.
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 2820 W CHARLESTON BLVD SUITE #6
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City | LAS VEGAS
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State | NV
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Zip | 89102-1942
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Country | US
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Telephone | 792-258-7860
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 W CHARLESTON BLVD SUITE #6
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City | LAS VEGAS
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State | NV
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Zip | 89102-1942
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT BRADY
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Credential | D.C.
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Telephone | 801-369-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B01369
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License Number State | NV
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