Provider Demographics
NPI:1245302959
Name:TERRIBILINI, CASEY JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:JAMES
Last Name:TERRIBILINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3880 S BASCOM AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2674
Mailing Address - Country:US
Mailing Address - Phone:408-371-0260
Mailing Address - Fax:408-371-2612
Practice Address - Street 1:3880 S BASCOM AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2674
Practice Address - Country:US
Practice Address - Phone:408-371-0260
Practice Address - Fax:408-371-2612
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18667111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health