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NPI 1700415205

NPI 1700415205 : MARCELLA BRADY : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1700415205
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    Entity Type          |    Individual 
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    Provider Name        |    MARCELLA BRADY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/06/2020
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    Last Update Date     |    10/16/2025
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Provider Practice Location Address
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    Address Line         |    RDL THERAPEUTIC OUTPATIENT THERAPY 424 MCARTHUR RD
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28311
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    Country              |    US
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    Telephone            |    910-868-2002
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3591 MURCHISON RD 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28311-2821
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    Country              |    US
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    Telephone            |    910-813-3202
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    A5071
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    11301
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    License Number State |    NC
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