Provider Demographics
NPI:1942703210
Name:BOLLIER, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BOLLIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10967 ALLISONVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2634
Mailing Address - Country:US
Mailing Address - Phone:317-577-0707
Mailing Address - Fax:
Practice Address - Street 1:10967 ALLISONVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2634
Practice Address - Country:US
Practice Address - Phone:317-577-0707
Practice Address - Fax:317-577-1567
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3600160456152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist