Provider Demographics
NPI:1740338318
Name:BRADY, DEBRA K (DC)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:K
Last Name:BRADY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FOULK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3644
Mailing Address - Country:US
Mailing Address - Phone:302-529-8783
Mailing Address - Fax:302-529-1586
Practice Address - Street 1:2006 FOULK RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3644
Practice Address - Country:US
Practice Address - Phone:302-529-8783
Practice Address - Fax:302-529-1586
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000458111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE293731OtherMAMSI
DE648926OtherUNITED HEALTHCARE
DE2129486000OtherAMERIHEALTHHMO
DE8407466OtherCIGNAPPO
DE1446151OtherAMERIHEALTHPPO
DE108375OtherCOVENTRY
DE648926OtherUNITED HEALTHCARE
DE003009R92Medicare ID - Type Unspecified