Individual
KASEY E CERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1202 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 835-8761
(575) 835-8763
Mailing address
1202 HIGHWAY 60, SOCORRO, NM 87801-3914
(758) 358-7615
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4442
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19457804
—
NM
Enumeration date
02/15/2018
Last updated
02/01/2023
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