Provider Demographics
NPI:1043330269
Name:CASIMIR, LOUIS J III (MSLAC)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:J
Last Name:CASIMIR
Suffix:III
Gender:M
Credentials:MSLAC
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:CASIMIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSLAC
Mailing Address - Street 1:115 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-2201
Mailing Address - Country:US
Mailing Address - Phone:570-523-3004
Mailing Address - Fax:570-523-0030
Practice Address - Street 1:115 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-2201
Practice Address - Country:US
Practice Address - Phone:570-523-3004
Practice Address - Fax:570-523-0030
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000609171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist