Provider Demographics
NPI:1174257620
Name:CASAD CHIROPRACTIC
Entity Type:Organization
Organization Name:CASAD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:707-778-7010
Mailing Address - Street 1:401 WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2346
Mailing Address - Country:US
Mailing Address - Phone:707-778-7010
Mailing Address - Fax:707-778-1222
Practice Address - Street 1:401 WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2346
Practice Address - Country:US
Practice Address - Phone:707-778-7010
Practice Address - Fax:707-778-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty