Individual
BRADY ROBERT COLLVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
774 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2609
(716) 665-1166
Mailing address
774 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2609
(716) 665-1166
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07746569
—
NY
Enumeration date
07/26/2023
Last updated
05/15/2026
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