Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 4087 | KY |
NPI | 1073738845 |
---|---|
Provider Name | Dr. Sean Patrick Brady |
First Address | Louisville, KY 40207-2555 |
Second Address | Louisville, KY 40207-2555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |