Provider Demographics
NPI:1306830914
Name:CASA, DOUGLAS JAMES (PHD, ATC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:JAMES
Last Name:CASA
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2568
Mailing Address - Country:US
Mailing Address - Phone:860-429-7720
Mailing Address - Fax:
Practice Address - Street 1:75 MAPLE RD
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-2568
Practice Address - Country:US
Practice Address - Phone:860-429-7720
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer