Provider Demographics
NPI:1447239132
Name:CASTEEL, MARK B (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:CASTEEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E LOCUST ST
Mailing Address - Street 2:PO BOX 248
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-2128
Mailing Address - Country:US
Mailing Address - Phone:814-342-4711
Mailing Address - Fax:814-342-1689
Practice Address - Street 1:210 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2128
Practice Address - Country:US
Practice Address - Phone:814-342-4711
Practice Address - Fax:814-342-1689
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002783L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009658640001Medicaid
PA0009658640001Medicaid