Fackrell, Wendell

Fackrell, Wendell is an sole proprietor health care provider with primary practice located at 421 N. Cole Rd. Ste 102 , Boise ID 83704. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fackrell, Wendell can be contacted via phone (208) 658-1068.

Contact Information

Primary practice address
421 N. Cole Rd. Ste 102 Boise ID 83704
Phone: (208) 658-1068
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100232 Idaho

Profile Details

NPI number 1750678298
LBN Legal business name Fackrell, Wendell
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2011
Last updated Aug 6th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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