Provider Demographics
NPI:1972676880
Name:DANKOVICH, DANIEL S (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:DANKOVICH
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 1:3660 STARR CENTRE DRIVE
Mailing Address - Street 2:#3
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406
Mailing Address - Country:US
Mailing Address - Phone:330-533-1315
Mailing Address - Fax:330-533-8839
Practice Address - Street 1:3660 STARR CENTRE DRIVE
Practice Address - Street 2:#3
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406
Practice Address - Country:US
Practice Address - Phone:330-533-1315
Practice Address - Fax:330-533-8839
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341353370-00OtherBWC
OH0864300Medicaid
OH0864300Medicaid
OH341353370-00OtherBWC