Individual
JORDAN WILLIAM BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 N 1700 W STE A, LAYTON, UT 84041-8804
(801) 773-1350
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
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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