NPI 1801171293

Dr Wendell R Fackrell PLLC

Organisation Optometrist Chubbuck, ID

Practice location

Address: 4145 Yellowstone Ave, Chubbuck, ID 83202-2421
Phone: (801) 722-5380

Authorised official

Name: Wendell Fackrell
Title: Optometrist, Owner
Phone: (801) 722-5380

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X

Other Optometrist providers in Idaho →

Registry record

NPI: 1801171293
Entity type: Organization
NPI issued: 17 Oct 2011
Record last updated: 17 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.