Individual
MR. BRADY BENJAMIN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPED, CFO
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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