Provider Demographics
NPI:1831383967
Name:CASPER, MARCIA (RDCS)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MAIN ST.
Mailing Address - Street 2:P.O.B. 175
Mailing Address - City:MACEDONIA
Mailing Address - State:IA
Mailing Address - Zip Code:51549-4060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:IA
Practice Address - Zip Code:51549-4060
Practice Address - Country:US
Practice Address - Phone:712-486-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARDMS 43927246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography