Individual
ZACHARY BLAKE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 MAIN ST SW, HANCEVILLE, AL 35077-5476
(256) 352-4767
(256) 352-4797
Mailing address
9338 DOSS FERRY LN, KIMBERLY, AL 35091-2030
(256) 620-0304
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-152297
AL
Other
Enumeration date
09/09/2019
Last updated
07/16/2021
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