Provider Demographics
NPI:1073322632
Name:RADMANN, BRADY
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:
Last Name:RADMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 S 110TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-2349
Mailing Address - Country:US
Mailing Address - Phone:262-993-7467
Mailing Address - Fax:
Practice Address - Street 1:N16W23217 STONE RIDGE DR STE 350
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1171
Practice Address - Country:US
Practice Address - Phone:844-206-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant