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General NPI Number Information
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NPI Number | 1639390370
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Entity Type | Individual
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Provider Name | JOHN MICHAEL DICAPO DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 1110 NE 85 CT
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City | KANSAS CITY
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State | MO
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Zip | 64155
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Country | US
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Telephone | 414-559-0960
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 NE 85 CT
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City | KANSAS CITY
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State | MO
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Zip | 64155
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Country | US
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Telephone | 414-559-0960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1103850
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2008004998
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2400609
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2008020470
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070017748
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License Number State | IL
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