Provider Demographics
NPI:1831478213
Name:MCGREW, CASEY (DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:MCGREW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CLANTON AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1495 VICTOR AVE
Practice Address - Street 2:SUITE D
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4093
Practice Address - Country:US
Practice Address - Phone:530-514-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist