Provider Demographics
NPI:1518736859
Name:CASEY, CEDAR R
Entity Type:Individual
Prefix:
First Name:CEDAR
Middle Name:R
Last Name:CASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1547 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1836
Mailing Address - Country:US
Mailing Address - Phone:740-575-1709
Mailing Address - Fax:
Practice Address - Street 1:1547 ADAMS ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1836
Practice Address - Country:US
Practice Address - Phone:740-575-1709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care