Provider Demographics
NPI:1225005242
Name:CASEY, AARON C (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:C
Last Name:CASEY
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 1:16 WALL ST
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1161
Mailing Address - Country:US
Mailing Address - Phone:860-537-2202
Mailing Address - Fax:860-537-8202
Practice Address - Street 1:16 WALL ST
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1161
Practice Address - Country:US
Practice Address - Phone:860-537-2202
Practice Address - Fax:860-537-8202
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTV09015Medicare UPIN