Provider Demographics
NPI:1003809476
Name:KASIK, JOHN JOSEPH SR (ATC, CPED)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:KASIK
Suffix:SR
Gender:M
Credentials:ATC, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 HUNTERS BLIND DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1651
Mailing Address - Country:US
Mailing Address - Phone:803-708-0199
Mailing Address - Fax:803-777-3135
Practice Address - Street 1:329 HUNTERS BLIND DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1651
Practice Address - Country:US
Practice Address - Phone:803-708-0199
Practice Address - Fax:803-777-3135
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter