Provider Demographics
NPI:1902480395
Name:DANIELS, MCKINZIE LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:MCKINZIE
Middle Name:LYNN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1421 S POTOMAC ST STE 130
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4511
Mailing Address - Country:US
Mailing Address - Phone:303-337-3937
Mailing Address - Fax:303-800-2078
Practice Address - Street 1:1421 S POTOMAC ST STE 130
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4511
Practice Address - Country:US
Practice Address - Phone:033-373-9373
Practice Address - Fax:303-800-2078
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist