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Individual
JORDAN WILLIAM BRADY
Active
Individual
JORDAN WILLIAM BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NULL
225100000X
Physical Therapist
Primary
10405007-2401
UT
225100000X
Physical Therapist
6623
ID
Other
Enumeration date
11/04/2014
Last updated
03/09/2023
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