Individual
ZACHERY ORION GLICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(813) 334-0730
Mailing address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(813) 334-0730
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
05/27/2025
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