Provider Demographics
NPI:1083071518
Name:KEESEE, CASSANDRA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:LEE
Last Name:KEESEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:SHEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:52 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1225
Mailing Address - Country:US
Mailing Address - Phone:248-302-8543
Mailing Address - Fax:
Practice Address - Street 1:52 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-1225
Practice Address - Country:US
Practice Address - Phone:740-967-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11766111N00000X
OHDC-05138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor