Provider Demographics
NPI:1790482396
Name:WEBBER, CASEY MARIE (DC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE
Last Name:WEBBER
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 1:518 MARMIK CIR
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-4042
Mailing Address - Country:US
Mailing Address - Phone:651-235-2857
Mailing Address - Fax:
Practice Address - Street 1:1380 N ACRES RD STE A
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:WI
Practice Address - Zip Code:54021-7061
Practice Address - Country:US
Practice Address - Phone:715-262-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6061-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor