OrganizationCasey Chiropractic PaChiropractorChiropractic ProvidersPractice Address403 S 11th St, Suite 110, Boise, ID 83702-6968(208) 378-7700PECOS EnrollmentBased on the most recent information from CMS, provider Casey Chiropractic Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1407966419Provider TypeOrganizationFull NameCasey Chiropractic PaSubpartNoEnumeration Date8/30/2006Last Updated3/14/2008Contact InformationPractice LocationPractice Address403 S 11th St, Suite 110, Boise, ID 83702-6968Phone(208) 378-7700Fax(208) 343-0642Mailing LocationMailing Address403 S 11th St, Suite 110, Boise, ID 83702-6968Phone(208) 378-7700Fax(208) 343-0642Authorized OfficialNameCasey, Patrick (Pres)Phone(208) 378-7700Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseCHIA929IdahoProvider IdentifiersIDDescriptionIssuerID00187DescriptionOtherIssuerBLUE SHIELDIdahoIDC1914DescriptionOtherIssuerBLUE CROSSIdaho