Provider Demographics
NPI:1518475888
Name:HAMBY, CASEY STAR (LMT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:STAR
Last Name:HAMBY
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 1:105 HEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45325-1207
Mailing Address - Country:US
Mailing Address - Phone:937-543-3647
Mailing Address - Fax:
Practice Address - Street 1:1 ELIZABETH PL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3445
Practice Address - Country:US
Practice Address - Phone:937-952-6567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.023863225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist