Healthcare Provider Details

I. General information

NPI: 1972588218
Provider Name (Legal Business Name): CURTIS RILEY CASADY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W ELLIOT RD STE 114
GILBERT AZ
85233-5301
US

IV. Provider business mailing address

725 W ELLIOT RD STE 114
GILBERT AZ
85233-5301
US

V. Phone/Fax

Practice location:
  • Phone: 480-545-0000
  • Fax: 480-545-7615
Mailing address:
  • Phone: 480-545-0000
  • Fax: 480-462-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number28931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: