Provider Demographics
NPI:1811491509
Name:STOWE-DANIEL, CLEMENTINE KIRBY (DO)
Entity type:Individual
Prefix:DR
First Name:CLEMENTINE
Middle Name:KIRBY
Last Name:STOWE-DANIEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CLEMENTINE
Other - Middle Name:
Other - Last Name:STOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2166 LOMBARDY ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-4188
Mailing Address - Country:US
Mailing Address - Phone:970-232-4708
Mailing Address - Fax:
Practice Address - Street 1:1950 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3129
Practice Address - Country:US
Practice Address - Phone:303-651-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0357207P00000X
CODR.0071084207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine