Provider Demographics
NPI:1649519331
Name:DAU, KAYLIE M (OD)
Entity type:Individual
Prefix:DR
First Name:KAYLIE
Middle Name:M
Last Name:DAU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 QUEBEC PKWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-4812
Mailing Address - Country:US
Mailing Address - Phone:303-655-4960
Mailing Address - Fax:
Practice Address - Street 1:6255 QUEBEC PKWY STE 1100
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-4812
Practice Address - Country:US
Practice Address - Phone:303-655-4960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist