Provider Demographics
NPI:1770753493
Name:VARICK, CASEY LEE JR (DC)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LEE
Last Name:VARICK
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719-9717
Mailing Address - Country:US
Mailing Address - Phone:605-791-2141
Mailing Address - Fax:
Practice Address - Street 1:214 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:SD
Practice Address - Zip Code:57719-9717
Practice Address - Country:US
Practice Address - Phone:605-791-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor