Individual
CHANCE BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1365 W UNIVERSITY BLVD, ODESSA, TX 79764-7121
(432) 580-0011
(432) 580-0044
Mailing address
2525 N GRANDVIEW AVE STE 400, ODESSA, TX 79761-1621
(432) 550-4700
(432) 550-4715
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1262088
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354385201
—
TX
Enumeration date
07/22/2015
Last updated
01/18/2017
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