Provider Demographics
NPI:1194327825
Name:CASPER CHIROPRACTIC
Entity type:Organization
Organization Name:CASPER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CASPER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:315-735-0903
Mailing Address - Street 1:101 HERKIMER RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-2311
Mailing Address - Country:US
Mailing Address - Phone:315-735-0903
Mailing Address - Fax:
Practice Address - Street 1:101 HERKIMER RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2311
Practice Address - Country:US
Practice Address - Phone:315-735-0903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty