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General NPI Number Information
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NPI Number | 1699585307
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Entity Type | Individual
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Provider Name | DANIEL ZACKS PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 360 WOOD ST
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City | LANDER
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State | WY
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Zip | 82520-2256
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Country | US
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Telephone | 760-902-5160
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Fax |
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Provider Business Mailing Address
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Address Line | 360 WOOD ST
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City | LANDER
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State | WY
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Zip | 82520-2256
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Country | US
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Telephone | 760-902-5160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | P05011
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License Number State | CA
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