Provider Demographics
NPI:1043490337
Name:KINCAID, CASEY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:MICHAEL
Last Name:KINCAID
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 1:4038 S TIMBERLINE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6031
Mailing Address - Country:US
Mailing Address - Phone:970-267-9600
Mailing Address - Fax:
Practice Address - Street 1:4038 S TIMBERLINE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6031
Practice Address - Country:US
Practice Address - Phone:970-267-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor