Provider Demographics
NPI:1649817198
Name:CASEY, CAITLIN ANN (LAT, ATC)
Entity type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:ANN
Last Name:CASEY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PLEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702-8523
Mailing Address - Country:US
Mailing Address - Phone:570-574-7048
Mailing Address - Fax:
Practice Address - Street 1:112 PLEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:BEAR CREEK TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18702-8523
Practice Address - Country:US
Practice Address - Phone:570-574-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0060122081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine