Provider Demographics
NPI:1033394945
Name:MCKEOWN, CASEY A (DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:A
Last Name:MCKEOWN
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 1:2106 ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-3940
Mailing Address - Country:US
Mailing Address - Phone:541-963-0339
Mailing Address - Fax:541-963-8882
Practice Address - Street 1:2106 ISLAND AVE
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3940
Practice Address - Country:US
Practice Address - Phone:541-963-0339
Practice Address - Fax:541-963-8882
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3792111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician