Provider Demographics
NPI:1477134278
Name:GEORGE, CASEY J II
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:J
Last Name:GEORGE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 EVERETT COMMUNITY RD
Mailing Address - Street 2:
Mailing Address - City:PINETOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27865-9312
Mailing Address - Country:US
Mailing Address - Phone:252-943-5390
Mailing Address - Fax:
Practice Address - Street 1:128 SNOW HILL ST
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-7237
Practice Address - Country:US
Practice Address - Phone:252-746-8223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10748225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist