Provider Demographics
NPI:1386851897
Name:CASEY J OIE CHIROPRACTIC PA
Entity Type:Organization
Organization Name:CASEY J OIE CHIROPRACTIC PA
Other - Org Name:BLAKE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-933-6235
Mailing Address - Street 1:172 BLAKE RD N
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8201
Mailing Address - Country:US
Mailing Address - Phone:952-933-6235
Mailing Address - Fax:952-933-0077
Practice Address - Street 1:172 BLAKE RD N
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8201
Practice Address - Country:US
Practice Address - Phone:952-933-6235
Practice Address - Fax:952-933-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty