Provider Demographics
NPI:1376857524
Name:BABINYECZ, CASEY D (LMT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:D
Last Name:BABINYECZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17900 JEFFERSON PARK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3437
Mailing Address - Country:US
Mailing Address - Phone:440-891-6299
Mailing Address - Fax:
Practice Address - Street 1:17900 JEFFERSON PARK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3437
Practice Address - Country:US
Practice Address - Phone:440-891-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.017119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist