Provider Demographics
NPI:1104827849
Name:BRADY, MARGO JONES (PT, DPT, CHT)
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:JONES
Last Name:BRADY
Suffix:
Gender:F
Credentials:PT, DPT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 S 900 E
Mailing Address - Street 2:#100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-6657
Mailing Address - Country:US
Mailing Address - Phone:801-261-3321
Mailing Address - Fax:801-261-5942
Practice Address - Street 1:5151 S 900 E
Practice Address - Street 2:#100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-6601
Practice Address - Country:US
Practice Address - Phone:801-261-3321
Practice Address - Fax:801-261-5942
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT109201-24012251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6400170OtherUNITED HEALTHCARE
UT27528OtherPEHP
UT870388269BR1OtherEDUCATORS MUTUAL
UT1108540001OtherCIGNA DMERC
UTP00218853OtherRAILROAD MEDICARE
UT33669373004OtherCIGNA
UT5417OtherDMBA
UTQM0000025584OtherALTIUS
UT107009230103OtherIHC
UT107009230103OtherIHC
UT1108540001OtherCIGNA DMERC
UT870388269BR1OtherEDUCATORS MUTUAL