Individual
MR. ZACHARY THOMAS FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT BASIC
Contact information
Practice address
BUILDING 301, ANDREWS AVE., LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7341
Mailing address
BUILDING 301, ANDREWS AVE., LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7341
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
B1918437
TX
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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