Individual
ZACHARY HUMPHRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 FOUNDERS LN, JACKSONVILLE, IL 62650-3919
(217) 243-0300
Mailing address
15 FOUNDERS LN, JACKSONVILLE, IL 62650-3919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/18/2020
Last updated
03/10/2022
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