Individual
DR. ZACKARY NATHAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1175 W BOISE AVE, BOISE, ID 83706-3503
(208) 384-9194
Mailing address
1175 W BOISE AVE, BOISE, ID 83706-3503
(208) 384-9194
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-1066
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806981700
—
ID
Enumeration date
10/04/2006
Last updated
07/09/2007
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