Provider Demographics
NPI:1790484566
Name:MCCASKEY, DAVID ALEX (ATC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALEX
Last Name:MCCASKEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:WILLITS
Other - Last Name:MCCASKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:766 HAZELWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4338
Mailing Address - Country:US
Mailing Address - Phone:614-581-5224
Mailing Address - Fax:
Practice Address - Street 1:860 ELM RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5109
Practice Address - Country:US
Practice Address - Phone:614-581-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0035902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer