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General NPI Number Information
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NPI Number | 1629753678
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Entity Type | Individual
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Provider Name | BRADY O MIERS DC
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Gender | Male
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 1113 W GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2602
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Country | US
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Telephone | 636-310-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 3827 SANDY CHURCH RD
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City | HILLSBORO
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State | MO
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Zip | 63050-2724
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Country | US
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Telephone | 314-941-8679
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2022015919
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License Number State | MO
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