Provider Demographics
NPI:1184862286
Name:OVERTON, CASEY LYN (RN, DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LYN
Last Name:OVERTON
Suffix:
Gender:F
Credentials:RN, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1744
Mailing Address - Country:US
Mailing Address - Phone:636-439-9890
Mailing Address - Fax:
Practice Address - Street 1:2315 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8659
Practice Address - Country:US
Practice Address - Phone:636-978-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20144038486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor