Provider Demographics
NPI:1811245251
Name:RHODUS, CASEE LEIGH (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:CASEE
Middle Name:LEIGH
Last Name:RHODUS
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 RICE RD APT 1C
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-3006
Mailing Address - Country:US
Mailing Address - Phone:601-810-3090
Mailing Address - Fax:
Practice Address - Street 1:715 RICE RD APT 1C
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-3006
Practice Address - Country:US
Practice Address - Phone:601-810-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT04122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer