Provider Demographics
NPI:1639584824
Name:BRADY, REBECCA (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JANE
Other - Last Name:ZENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4808 EDGECLIFF CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9334
Mailing Address - Country:US
Mailing Address - Phone:919-621-0754
Mailing Address - Fax:
Practice Address - Street 1:300 KILDAIRE WOODS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5500
Practice Address - Country:US
Practice Address - Phone:919-234-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP4034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist