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General NPI Number Information
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NPI Number | 1033294251
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Entity Type | Individual
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Provider Name | CLINTON A. ALUISE A.B.O.C.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 618 WALNUT AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7400
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Country | US
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Telephone | 970-244-8665
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Fax | 970-244-6995
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Provider Business Mailing Address
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Address Line | 2442 GUNNISON AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7948
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Country | US
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Telephone | 970-244-8480
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Fax | 970-244-6995
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 05717
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License Number State | CO
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