Healthcare Provider Details

I. General information

NPI: 1720694540
Provider Name (Legal Business Name): DANIEL JOSEPH OTIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W MAIN ST STE 202
FRISCO CO
80443-5966
US

IV. Provider business mailing address

PO BOX 8851
AVON CO
81620-8829
US

V. Phone/Fax

Practice location:
  • Phone: 970-368-2764
  • Fax:
Mailing address:
  • Phone: 970-368-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR0008996
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: