Provider Demographics
NPI:1588980411
Name:BIRD, BRADY JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:BRADY
Middle Name:JOSEPH
Last Name:BIRD
Suffix:
Gender:M
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:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-0338
Mailing Address - Country:US
Mailing Address - Phone:319-455-6554
Mailing Address - Fax:
Practice Address - Street 1:2721 120TH ST NE STE 2
Practice Address - Street 2:
Practice Address - City:SWISHER
Practice Address - State:IA
Practice Address - Zip Code:52338-9578
Practice Address - Country:US
Practice Address - Phone:319-455-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007321111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111N00000XChiropractic ProvidersChiropractor