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General NPI Number Information
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NPI Number | 1790484566
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Entity Type | Individual
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Provider Name | DAVID ALEX MCCASKEY ATC
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Gender | Male
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 860 ELM RD NE
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City | WARREN
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State | OH
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Zip | 44483-5109
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Country | US
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Telephone | 614-581-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 766 HAZELWOOD AVE SE
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City | WARREN
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State | OH
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Zip | 44484-4338
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Country | US
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Telephone | 614-581-5224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003590
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License Number State | OH
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