Provider Demographics
NPI:1972566560
Name:MERHEGE, BRAD K (PT)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:K
Last Name:MERHEGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 N 31ST PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3702
Mailing Address - Country:US
Mailing Address - Phone:480-294-3488
Mailing Address - Fax:
Practice Address - Street 1:5326 N 31ST PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3702
Practice Address - Country:US
Practice Address - Phone:480-294-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist