Provider Demographics
NPI:1518599232
Name:BRADY, KATHERINE LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:BRADY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WODENSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8738
Mailing Address - Country:US
Mailing Address - Phone:570-275-1567
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIC REHABILITATION 100 NORTH ACADEMY AVENUE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-0001
Practice Address - Country:US
Practice Address - Phone:570-271-5314
Practice Address - Fax:570-271-6793
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA003051E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist