Provider Demographics
NPI:1639342967
Name:BRENDA CASEY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:BRENDA CASEY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-492-0122
Mailing Address - Street 1:15545 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1434
Mailing Address - Country:US
Mailing Address - Phone:913-894-4428
Mailing Address - Fax:913-894-4427
Practice Address - Street 1:15545 W 87TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1434
Practice Address - Country:US
Practice Address - Phone:913-894-4428
Practice Address - Fax:913-894-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU80457Medicare UPIN
KSH487899Medicare PIN