Provider Demographics
NPI:1376824250
Name:REIN, CASEY (LAC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:REIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9814 GATESBURY CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-6839
Mailing Address - Country:US
Mailing Address - Phone:303-503-0403
Mailing Address - Fax:
Practice Address - Street 1:7601 SOUTH UNIVERSITY BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-730-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1398171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist