Provider Demographics
NPI:1326718271
Name:BRADY SANDERCOCK PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:BRADY SANDERCOCK PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-984-7665
Mailing Address - Street 1:2209 BARKER CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6197
Mailing Address - Country:US
Mailing Address - Phone:610-984-7665
Mailing Address - Fax:
Practice Address - Street 1:2209 BARKER CIR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6197
Practice Address - Country:US
Practice Address - Phone:610-984-7665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRADY SANDERCOCK PHYSICAL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty