Individual
DR. JARED BRACKENRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3706 S MAIN ST, BLACKSBURG, VA 24060-7006
(540) 951-3376
(540) 951-1276
Mailing address
3706 S MAIN ST, STE B, BLACKSBURG, VA 24060-7006
(540) 951-3376
(540) 951-1276
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0102206597
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2017
Last updated
08/18/2021
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