Provider Demographics
NPI:1619990736
Name:CASBERE, JOHN STANLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STANLEY
Last Name:CASBERE
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:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:OH
Mailing Address - Zip Code:43517-0459
Mailing Address - Country:US
Mailing Address - Phone:419-298-1700
Mailing Address - Fax:
Practice Address - Street 1:113 W LYNN ST
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:OH
Practice Address - Zip Code:43517-9597
Practice Address - Country:US
Practice Address - Phone:419-298-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0386141Medicare ID - Type Unspecified