Provider Demographics
NPI:1780707729
Name:CASEY, VINCENT JEROME (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:JEROME
Last Name:CASEY
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5266 SIMONS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1871
Mailing Address - Country:US
Mailing Address - Phone:775-747-7819
Mailing Address - Fax:
Practice Address - Street 1:5150 MAE ANNE AVE STE 405
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1859
Practice Address - Country:US
Practice Address - Phone:775-747-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor