Provider Demographics
NPI:1215179270
Name:WEERHEIM, CASEY (DC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:WEERHEIM
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 1:3505 W 93RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-6365
Mailing Address - Country:US
Mailing Address - Phone:563-271-9638
Mailing Address - Fax:
Practice Address - Street 1:429 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3824
Practice Address - Country:US
Practice Address - Phone:563-271-9638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD27-2258317Medicare PIN