NPI 1326857137

Zachery Orion Glickman

Practitioner Independent Duty Medical Technicians Mountain Home Afb, ID

Practice location

Address: 90 Hope Dr, Mountain Home Afb, ID 83648-1057
Phone: (813) 334-0730

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

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Registry record

NPI: 1326857137
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jan 2025
Record last updated: 27 May 2025

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.