Provider Demographics
NPI:1811904402
Name:M. CASEY CHIRO-CARE LLC
Entity type:Organization
Organization Name:M. CASEY CHIRO-CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-377-0560
Mailing Address - Street 1:7639 W BELOIT RD
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53219-2447
Mailing Address - Country:US
Mailing Address - Phone:414-377-0560
Mailing Address - Fax:414-377-0546
Practice Address - Street 1:7639 W BELOIT RD
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53219-2447
Practice Address - Country:US
Practice Address - Phone:414-543-1951
Practice Address - Fax:414-543-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3570-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38924600Medicaid
WI38924600Medicaid