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1164455887

NPI Code Detail

MEDICARE: MR. BRADY K ENGLESTEAD M.P.T.

MEDICARE: MR. BRADY K ENGLESTEAD M.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	277598-2401	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	650019319	OTHER	UT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107009571103	OTHER	UT	SELECT HEALTH
3	190649300	OTHER	UT	OWCP
4	638841	OTHER	UT	DMBA
5	94277598204001	OTHER	UT	BCBS TRADITONAL
6	PRA03531	OTHER	UT	MOLINA
7	080086	OTHER	UT	IHC SELECT MED
8	870656237BE1	OTHER	UT	EDUCATORS MUTUAL
9	59795	OTHER	UT	PEHP
10	94277598202001	OTHER	UT	BCBS PPO
11	2012098	OTHER	UT	FIRST HEALTH
12	5650341	OTHER	UT	AETNA
13	64-00636	OTHER	UT	UNITED HEALT CARE

General Provider Information

NPI Number	:	1164455887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRADY K ENGLESTEAD M.P.T.

Provider Business Mailing Address
First Line	:	166 W 1325 N
Second Line	:	SUITE 100
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-7792
Country	:	US
Telephone Number	:	435-586-0064
Fax Number	:	435-867-1243

Provider Business Practice Location Address
First Line	:	166 W 1325 N
Second Line	:	SUITE 100
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-7792
Country	:	US
Telephone Number	:	435-586-0064
Fax Number	:	435-867-1243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1780600049 — MR. ADAM L MENDENHALL M.P.T.
Practice Location Address:

166 W 1325 N , SUITE 100
CEDAR CITY, UT
84720-7792

Practice Phone: 435-586-0064
Practice Fax: 435-867-1243

1386660637 — MR. GAIL TYLER BRINKERHOFF M.S.P.T.
Practice Location Address:

166 W 1325 N , SUITE 100
CEDAR CITY, UT
84720-7792

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Practice Fax: 435-867-1243

1417976499 — TORI B FORSYTH P.T.
Practice Location Address:

166 W 1325 N , STE 100
CEDAR CITY, UT
84720-7792

Practice Phone: 435-586-0064
Practice Fax: 435-867-1243

1528087236 — MICHAEL G STULTS MD
Practice Location Address:

166 W 1325 N , #350
CEDAR CITY, UT
84720-7792

Practice Phone: 435-586-8192
Practice Fax:

1780606848 — CHAD R FLETCHER O.T.R.L
Practice Location Address:

166 W 1325 N , STE 100
CEDAR CITY, UT
84720-7792

Practice Phone: 435-586-0064
Practice Fax: 435-867-1243

1194735225 — GARLAND EARWOOD O.T. R. L.
Practice Location Address:

166 W 1325 N , STE 100
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Practice Phone: 435-586-0064
Practice Fax: 435-867-1243

Directions to “ MR. BRADY K ENGLESTEAD M.P.T.” Practice Location

Language	Start Address	Practice Location

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