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General NPI Number Information
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NPI Number | 1912162041
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Entity Type | Individual
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Provider Name | BRENT MICHAEL ZOLLER D.C
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Gender | Male
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 8241 CORNELL RD SUITE #200
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City | CINCINNATI
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State | OH
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Zip | 45249-2283
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Country | US
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Telephone | 513-777-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 9641 FOXHOUND DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-5572
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Country | US
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Telephone | 937-239-4044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3899
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License Number State | OH
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