Provider Demographics
NPI:1063820157
Name:FOLEY, CASEY ALYSON (DPT)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ALYSON
Last Name:FOLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ALYSON
Other - Last Name:KELLOGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 DAVIS ST STE B
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7009
Mailing Address - Country:US
Mailing Address - Phone:540-552-5100
Mailing Address - Fax:540-552-5700
Practice Address - Street 1:825 DAVIS ST STE B
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7009
Practice Address - Country:US
Practice Address - Phone:540-552-5100
Practice Address - Fax:540-552-5700
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29479225100000X
VA2305211399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305211399OtherPT LICENSE
FLPT29479OtherLICENSE