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ROGER JOHN CASEY ATC
Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1730428699
Individual Registrant: ROGER JOHN CASEY ATC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
12280 228TH ST N SCANDIA, MN 55073-9467 US
Tel: 651-399-8497 Fax: --
Tel: 651-399-8497 Fax: --
Contact information for business:
12280 228TH ST N SCANDIA, MN 55073-9467 US
Tel: 651-399-8497 Fax: --
Tel: 651-399-8497 Fax: --
Registration Information:
NPI: 1730428699
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Athletic Trainer | MN | 1109 |
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor | MN | 304448 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
