Basic Information
| Provider Information | |||||||||
| NPI: | 1033474143 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VERONIE | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MS, PA-C, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5890 W 13TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806344821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703480020 | ||||||||
| FaxNumber: | 9703480044 | ||||||||
| Practice Location | |||||||||
| Address1: | 5890 W 13TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806344821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703480020 | ||||||||
| FaxNumber: | 9703480044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2012 | ||||||||
| LastUpdateDate: | 07/23/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA.0003493 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.