Provider Demographics
NPI:1598004038
Name:CASEY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CASEY CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-385-9999
Mailing Address - Street 1:801 SHADES CREST RD STE B
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1913
Mailing Address - Country:US
Mailing Address - Phone:205-385-9999
Mailing Address - Fax:205-358-0124
Practice Address - Street 1:801 SHADES CREST RD STE B
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-1913
Practice Address - Country:US
Practice Address - Phone:205-385-9999
Practice Address - Fax:205-358-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2354305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization