MEDICARE: PT2U LLC

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

General Provider Information

NPI Number	:	1649976036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PT2U LLC

Provider Business Mailing Address
First Line	:	205 ELM ST
Second Line	:
City	:	PHOENIX
State	:	OR
Zip	:	97535-7759
Country	:	US
Telephone Number	:	512-751-7395
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 ELM ST
Second Line	:
City	:	PHOENIX
State	:	OR
Zip	:	97535-7759
Country	:	US
Telephone Number	:	512-751-7395
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEREMY BRADY
Credential	:	DPT
Telephone Number	:	512-751-7395

Provider Enumeration Date	:	02/07/2023
Last Update Date	:	02/09/2023

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Directions to “PT2U LLC ” Practice Location

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