Provider Demographics
NPI:1295970176
Name:CASEY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:CASEY CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:EMMETT
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-269-9909
Mailing Address - Street 1:2301 EL CAJON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1105
Mailing Address - Country:US
Mailing Address - Phone:619-269-9909
Mailing Address - Fax:619-269-6906
Practice Address - Street 1:2301 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1105
Practice Address - Country:US
Practice Address - Phone:619-269-9909
Practice Address - Fax:619-269-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty