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1447356530
WAYNE LEE BRACKENRICH
ROANOKE, VA
NPI
1447356530
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: VA 0102033442)
Enumeration Date
2006-09-15
Last Update Date
2024-06-26
Business Address
WAYNE LEE BRACKENRICH D.O.
6415 PETERS CREEK RD
ROANOKE, VA 24019-4021
Phone number: 540-265-5500
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Mailing Address
WAYNE LEE BRACKENRICH D.O.
213 S JEFFERSON ST STE 1006
ROANOKE, VA 24011-1713
Phone number: 540-224-5705
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