Provider Demographics
NPI:1932336641
Name:WHITE, BRADY L (RRT,RCP,RPSGT)
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:RRT,RCP,RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 33RD ST SW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1638
Mailing Address - Country:US
Mailing Address - Phone:828-781-7413
Mailing Address - Fax:704-325-0812
Practice Address - Street 1:331 33RD ST SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1638
Practice Address - Country:US
Practice Address - Phone:828-781-7413
Practice Address - Fax:704-325-0812
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-5592279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Diagnostics