Provider Demographics
NPI:1326444175
Name:CASPER, PRESTON C (DPT)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:C
Last Name:CASPER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 THOMAS DR
Mailing Address - Street 2:APT 6
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-7716
Mailing Address - Country:US
Mailing Address - Phone:717-433-4764
Mailing Address - Fax:
Practice Address - Street 1:2250 MILLENNIUM WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1488
Practice Address - Country:US
Practice Address - Phone:717-732-8131
Practice Address - Fax:717-732-8132
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist