Provider Demographics
NPI:1619034568
Name:COLLMAR, DAVI JO
Entity Type:Individual
Prefix:MRS
First Name:DAVI
Middle Name:JO
Last Name:COLLMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2089 EASTERN RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4613
Mailing Address - Country:US
Mailing Address - Phone:330-861-0391
Mailing Address - Fax:
Practice Address - Street 1:2089 EASTERN RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4613
Practice Address - Country:US
Practice Address - Phone:330-861-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide