Provider Demographics
NPI:1396443297
Name:CASEY, CALLEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:CALLEY
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ROCHESTER RD STE GL-01
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4378
Mailing Address - Country:US
Mailing Address - Phone:248-650-1515
Mailing Address - Fax:248-650-1514
Practice Address - Street 1:6700 N ROCHESTER RD STE GL-01
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-4378
Practice Address - Country:US
Practice Address - Phone:248-650-1515
Practice Address - Fax:248-650-1514
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501302423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist