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Individual

MARY LEE BRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
8712 FRANKFORD AVE, 1A, PHILADELPHIA, PA 19136-1300
(215) 332-7828
(215) 332-7824
Mailing address
8712 FRANKFORD AVE, 1A, PHILADELPHIA, PA 19136-1300
(215) 332-7828
(215) 332-7824

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-002993-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0061117000
KEYSTONE 65
PA
05
1013353
PA
01
1059212
KEYSTONE FIRST
PA
01
187672
PERSONAL CHOICE
PA
Enumeration date
07/07/2005
Last updated
05/05/2016
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