Individual
DR. DENVER JOSEPH MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4719 W STATE ROAD 46, BLOOMINGTON, IN 47404-9518
(812) 876-2020
(812) 935-2020
Mailing address
744 E 3RD ST, ROOM 128, BLOOMINGTON, IN 47405-3603
(812) 856-5602
(812) 855-6116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003600
IN
152W00000X
Optometrist
4901004616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200945160
—
IN
Enumeration date
06/24/2009
Last updated
11/01/2023
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