Provider Demographics
NPI:1780005116
Name:PAYNE, KASEY MARIE (DC)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:MARIE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:MARIE
Other - Last Name:HEICHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENT
Mailing Address - State:MN
Mailing Address - Zip Code:55947-1828
Mailing Address - Country:US
Mailing Address - Phone:507-895-8100
Mailing Address - Fax:608-268-9710
Practice Address - Street 1:306 MAIN ST
Practice Address - Street 2:STE 101
Practice Address - City:LA CRESCENT
Practice Address - State:MN
Practice Address - Zip Code:55947-1828
Practice Address - Country:US
Practice Address - Phone:507-895-8100
Practice Address - Fax:608-268-9710
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5865111N00000X
WI5008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor