Organization
LEB PERIOPERATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUKE E BRACKE M.D. (OWNER)
(208) 525-2090
Entity
Organization
Contact information
Practice address
707 SHERIDAN AVE, CODY, WY 82414-3409
(307) 587-2139
Mailing address
PO BOX 3112, IDAHO FALLS, ID 83403-3112
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
WY
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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