Provider Demographics
NPI:1558881094
Name:KASIK, CAROLINE G (DC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:G
Last Name:KASIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1842
Mailing Address - Country:US
Mailing Address - Phone:410-251-7173
Mailing Address - Fax:
Practice Address - Street 1:2908 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1842
Practice Address - Country:US
Practice Address - Phone:410-251-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5542111N00000X
SC4591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor