Individual
KEVIN WILLIAM CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
2000 N LINDEN ST, B107, NORMAL, IL 61761-5321
(309) 530-4741
Mailing address
2000 N LINDEN ST, B107, NORMAL, IL 61761-5321
(309) 530-4741
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002782
IL
Other
Enumeration date
09/08/2013
Last updated
09/08/2013
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