Provider Demographics
NPI:1659834109
Name:CASEY, MEGHAN (PT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:PT
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 1813
Mailing Address - Street 2:
Mailing Address - City:CROWNPOINT
Mailing Address - State:NM
Mailing Address - Zip Code:87313-1813
Mailing Address - Country:US
Mailing Address - Phone:919-619-6575
Mailing Address - Fax:
Practice Address - Street 1:HWY 371 & ROUTE 9 JUNCTION
Practice Address - Street 2:
Practice Address - City:CROWNPOINT
Practice Address - State:NM
Practice Address - Zip Code:97313
Practice Address - Country:US
Practice Address - Phone:505-786-6291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist