Provider Demographics
NPI:1346060167
Name:ZACKARY, BRITT ANTHONY JR
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:ANTHONY
Last Name:ZACKARY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 WELL FLEET DR
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1417
Mailing Address - Country:US
Mailing Address - Phone:937-301-3357
Mailing Address - Fax:
Practice Address - Street 1:119 JONQUIL ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-7843
Practice Address - Country:US
Practice Address - Phone:937-944-4595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care