Provider Demographics
NPI:1477617413
Name:CASEY, BEAU EMMETT (DC)
Entity Type:Individual
Prefix:DR
First Name:BEAU
Middle Name:EMMETT
Last Name:CASEY
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 1:678 WHARTON BLVD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1189
Mailing Address - Country:US
Mailing Address - Phone:484-818-3373
Mailing Address - Fax:
Practice Address - Street 1:678 WHARTON BLVD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1189
Practice Address - Country:US
Practice Address - Phone:484-818-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28932111N00000X
PADC011410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor