Provider Demographics
NPI:1023199700
Name:CASEY, MICHAEL F (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:F
Last Name:CASEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LITTLE CONESTOGA RD
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-1816
Mailing Address - Country:US
Mailing Address - Phone:610-942-9613
Mailing Address - Fax:610-903-1041
Practice Address - Street 1:50 DEVON DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1783
Practice Address - Country:US
Practice Address - Phone:610-363-6400
Practice Address - Fax:610-903-1041
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001099A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer