Individual
MR. ZACHARY MARK BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
50 S BROADWAY AVE, SUITE B, BOISE, ID 83702-7283
(208) 377-3179
Mailing address
11250 W ROSE LAKE ST, STAR, ID 83669-5885
(208) 936-0333
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA-1106
ID
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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