Individual
ZACHARY BADGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1104 W IRONWOOD DR, COEUR D ALENE, ID 83814-2605
(208) 676-1003
Mailing address
1104 W IRONWOOD DR, COEUR D ALENE, ID 83814-2605
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-5493
ID
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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