Individual
BRADY K WHETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, GCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5636
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245938
—
OR
Enumeration date
05/28/2008
Last updated
07/07/2011
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