Individual
MR. CHARLES IRA CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1485 N TURQUOISE DR, FLAGSTAFF, AZ 86001-1398
(928) 774-6626
Mailing address
4760 S BRIGHT ANGEL TRL, FLAGSTAFF, AZ 86001-8366
(928) 699-2997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5297
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
532855
—
AZ
Enumeration date
08/31/2006
Last updated
07/08/2007
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