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General NPI Number Information
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NPI Number | 1548058829
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Entity Type | Individual
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Provider Name | DYLAN O CLAUSEN DC
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Gender | Male
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 5020 E BAY DR STE 500
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City | CLEARWATER
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State | FL
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Zip | 33764-5726
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Country | US
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Telephone | 727-475-7683
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Fax |
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Provider Business Mailing Address
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Address Line | 11335 112TH ST
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City | LARGO
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State | FL
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Zip | 33778-3108
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Country | US
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Telephone | 727-480-9897
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15287
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License Number State | FL
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