Provider Demographics
NPI:1871033613
Name:YORK, CASEY (MED LAT ATC)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:
Last Name:YORK
Suffix:
Gender:M
Credentials:MED LAT ATC
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 35
Mailing Address - Street 2:
Mailing Address - City:STURKIE
Mailing Address - State:AR
Mailing Address - Zip Code:72578-0035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5520 STURKIE RD
Practice Address - Street 2:
Practice Address - City:STURKIE
Practice Address - State:AR
Practice Address - Zip Code:72578-0035
Practice Address - Country:US
Practice Address - Phone:870-371-0367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer