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General NPI Number Information
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NPI Number | 1225299407
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Entity Type | Individual
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Provider Name | DANIEL PAUL CLOUSING O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | 210 ELIZABETH ST SUITE 'B'
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City | ELIZABETH
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State | CO
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Zip | 80107-7538
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Country | US
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Telephone | 303-646-8888
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Fax | 303-646-8880
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Provider Business Mailing Address
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Address Line | 18488 KEYSER CREEK AVE
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City | PARKER
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State | CO
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Zip | 80134-7670
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Country | US
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Telephone | 616-446-0041
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-2654
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License Number State | CO
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