Provider Demographics
NPI:1891828216
Name:WILLIAM F. BRADY DCPC
Entity type:Organization
Organization Name:WILLIAM F. BRADY DCPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-367-3110
Mailing Address - Street 1:15 COURT SQ
Mailing Address - Street 2:SUITE 840
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-2503
Mailing Address - Country:US
Mailing Address - Phone:617-367-3110
Mailing Address - Fax:617-367-3101
Practice Address - Street 1:15 COURT SQ
Practice Address - Street 2:SUITE 840
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-2503
Practice Address - Country:US
Practice Address - Phone:617-367-3110
Practice Address - Fax:617-367-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty