Provider Demographics
NPI:1942496062
Name:CASEY, THOMAS A (MS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:A
Last Name:CASEY
Suffix:
Gender:M
Credentials:MS
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 4235
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-0004
Mailing Address - Country:US
Mailing Address - Phone:804-539-1217
Mailing Address - Fax:
Practice Address - Street 1:21641 FARMERS LN
Practice Address - Street 2:
Practice Address - City:JETERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23083-2850
Practice Address - Country:US
Practice Address - Phone:804-539-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000259231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist