Provider Demographics
NPI:1851312292
Name:SANTELLI, DANA J (DC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:J
Last Name:SANTELLI
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 1:890 W CORSICANA ST STE 5
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-2260
Mailing Address - Country:US
Mailing Address - Phone:903-677-1936
Mailing Address - Fax:903-677-2193
Practice Address - Street 1:890 W CORSICANA ST STE 5
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2260
Practice Address - Country:US
Practice Address - Phone:903-677-1936
Practice Address - Fax:903-677-2193
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U49852Medicare UPIN
TX84Z720Medicare PIN