Individual
MR. BRADY BENJAMIN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPED, CFO
Contact information
Practice address
5923 CLARK RD, STE C, PARADISE, CA 95969
(530) 872-3710
(530) 872-7234
Mailing address
5923 CLARK RD, STE C, PARADISE, CA 95969
(530) 872-3710
(530) 872-7234
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
—
225000000X
Orthotic Fitter
—
—
Other
Enumeration date
09/22/2010
Last updated
12/08/2014
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