Provider Demographics
NPI:1316422389
Name:CALVERT, CASEY R (MSOP, CPO)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:R
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MSOP, CPO
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:R
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSOP, CPO
Mailing Address - Street 1:6514 ODANA RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1124
Mailing Address - Country:US
Mailing Address - Phone:608-833-9660
Mailing Address - Fax:608-833-4733
Practice Address - Street 1:6514 ODANA RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1124
Practice Address - Country:US
Practice Address - Phone:608-833-9660
Practice Address - Fax:608-833-4733
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist