MEDICARE: BRADY HUTCHINSON DPT

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	2251X0800X	Orthopedic Physical Therapist	2305215690	VA

General Provider Information

NPI Number	:	1598455313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADY HUTCHINSON DPT

Provider Business Mailing Address
First Line	:	PO BOX 715868
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19171-5868
Country	:	US
Telephone Number	:	804-915-1910
Fax Number	:

Provider Business Practice Location Address
First Line	:	12216 W BROAD ST STE 4B-5
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-1062
Country	:	US
Telephone Number	:	804-915-1910
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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