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General NPI Number Information
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NPI Number | 1598270233
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Entity Type | Individual
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Provider Name | BRENDA CLAIRE BRADY ATC/LAT
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Gender | Female
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 12/04/2017
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Provider Practice Location Address
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Address Line | 2702 8TH AVE N
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City | BILLINGS
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State | MT
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Zip | 59101-1107
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Country | US
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Telephone | 406-238-2136
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | WINNETT
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State | MT
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Zip | 59087-0128
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Country | US
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Telephone | 406-850-8826
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATR-LAT-LIC-89
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License Number State | MT
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