Provider Demographics
NPI:1700493814
Name:ZOLLER, DAISY RENEE
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:RENEE
Last Name:ZOLLER
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 1:8906 HARRISON PIKE
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-9757
Mailing Address - Country:US
Mailing Address - Phone:513-708-7442
Mailing Address - Fax:
Practice Address - Street 1:8906 HARRISON PIKE
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-9757
Practice Address - Country:US
Practice Address - Phone:513-708-7442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care