Individual
WAYNE LEE BRACKENRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6415 PETERS CREEK RD, ROANOKE, VA 24019-4021
(540) 265-5500
(540) 265-5515
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5705
(540) 562-4278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102033442
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005696101
—
VA
05
—
1447356530
—
VA
Enumeration date
09/15/2006
Last updated
06/26/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us