SearchIdaho152W00000X

Wendell Fackrell, O.D

NPI 1750678298 · on the registry since 2011 · sole proprietor

Practice

Address
421 N. Cole Rd. Ste 102
Boise, ID 83704
Phone
(208) 658-1068

Registry record

Primary taxonomy
152W00000X
152W00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-08-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho