Individual
BRADY LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 POTOMAC ST NW STE 106, WASHINGTON, DC 20007-3599
(301) 885-7746
Mailing address
414 MOHICAN DR, FREDERICK, MD 21701
(301) 885-7746
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0001005
MD
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/27/2016
Last updated
08/05/2019
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