Provider Demographics
NPI:1326176264
Name:DECANIO, DONALD FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:FRANK
Last Name:DECANIO
Suffix:
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 1:15261 S ACUFF ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3669
Mailing Address - Country:US
Mailing Address - Phone:913-530-3347
Mailing Address - Fax:913-780-5532
Practice Address - Street 1:15261 S ACUFF ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3669
Practice Address - Country:US
Practice Address - Phone:913-530-3347
Practice Address - Fax:913-780-5532
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04893111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition