Provider Demographics
NPI:1649694605
Name:ROGERS, CASEY LAREE (DC)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LAREE
Last Name:ROGERS
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 1:13 PALOMINO CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6031
Mailing Address - Country:US
Mailing Address - Phone:530-718-9525
Mailing Address - Fax:916-891-5095
Practice Address - Street 1:2775 COTTAGE WAY STE 33
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1230
Practice Address - Country:US
Practice Address - Phone:530-718-9525
Practice Address - Fax:916-891-5095
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor