# JORDAN WILLIAM BRADY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477959328
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 225100000X | Physical Therapist | 10405007-2401 | UT | Yes |
| 225100000X | Physical Therapist | 6623 | ID | — |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 03/09/2023