Individual
BRADY VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2130 STOUT ST, DENVER, CO 80205-2827
(303) 293-2217
Mailing address
2130 STOUT ST, DENVER, CO 80205-2827
(303) 293-2217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1642433
CO
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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