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NPI Code Detail

MEDICARE: BRADY KALLA

MEDICARE: BRADY KALLA
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1962170613
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADY KALLA
Provider Business Mailing Address
First Line : PO BOX 7197
Second Line :
City : ROCHESTER
State : MN
Zip : 55903-7197
Country : US
Telephone Number : 507-322-3460
Fax Number :
Provider Business Practice Location Address
First Line : 1309 SALEM RD SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-0993
Country : US
Telephone Number : 507-322-3460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2021
Last Update Date : 08/30/2021

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Directions to “ BRADY KALLA ” Practice Location

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