Provider Demographics
NPI:1275235368
Name:JONES, BRADY
Entity Type:Individual
Prefix:MR
First Name:BRADY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 KIRKLAND CT APT 114
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1725
Mailing Address - Country:US
Mailing Address - Phone:606-402-0002
Mailing Address - Fax:
Practice Address - Street 1:2511 KIRKLAND CT APT 114
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-1725
Practice Address - Country:US
Practice Address - Phone:606-402-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer