Provider Demographics
NPI:1750553269
Name:CASTONA, CASEY JEROME (CA, MSOM)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:JEROME
Last Name:CASTONA
Suffix:
Gender:M
Credentials:CA, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S BARSTOW ST STE A
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4979
Mailing Address - Country:US
Mailing Address - Phone:715-379-6429
Mailing Address - Fax:
Practice Address - Street 1:705 S BARSTOW ST STE A
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4979
Practice Address - Country:US
Practice Address - Phone:715-379-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU 1322171100000X
WI538-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist