Provider Demographics
NPI:1891997391
Name:DAVIDSON, CASEY ROWAN (DC)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:ROWAN
Last Name:DAVIDSON
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 1:28 FOUNTAIN SQ
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-8790
Mailing Address - Country:US
Mailing Address - Phone:931-456-2287
Mailing Address - Fax:931-456-2297
Practice Address - Street 1:28 FOUNTAIN SQ
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-8790
Practice Address - Country:US
Practice Address - Phone:931-456-2287
Practice Address - Fax:931-456-2297
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002189111N00000X
FLCH 9376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427229343OtherGROUP NPI