Provider Demographics
NPI:1437596038
Name:BRADY, ANDREW T (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:BRADY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 CORPORATE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4444
Mailing Address - Country:US
Mailing Address - Phone:234-284-8002
Mailing Address - Fax:234-284-8044
Practice Address - Street 1:1340 CORPORATE DR STE 300
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4444
Practice Address - Country:US
Practice Address - Phone:234-284-8002
Practice Address - Fax:234-284-8002
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor