Brady, Robert G

Brady, Robert G is an individual health care provider with primary practice located at 330 Packerland Dr , Green Bay WI 54303-4816. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is his primary health care specialty. Brady, Robert G can be contacted via phone (920) 857-1622.

Contact Information

Primary practice address
330 Packerland Dr Green Bay WI 54303-4816
Phone: (920) 857-1622
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 9918-24 Wisconsin

Profile Details

NPI number 1578666863
LBN Legal business name Brady, Robert G
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Sep 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578666863 NPPES
Wisconsin Other 9918-024 LICENSE NUMBER
Wisconsin MEDICAID 40375700 LICENSE NUMBER

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