Brackenrich, Michael Dale
Brackenrich, Michael Dale is an individual health care provider with primary practice located at 363 Woodland St , Rich Creek VA 24147-0336. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Brackenrich, Michael Dale can be contacted via phone (540) 726-2375.Contact Information
Primary practice address
363 Woodland St
Rich Creek VA 24147-0336
Phone: (540) 726-2375
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0102036943 | Virginia |
Profile Details
| NPI number | 1972603744 |
|---|---|
| LBN Legal business name | Brackenrich, Michael Dale |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jan 28th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972603744 | NPPES |
| Virginia | MEDICAID | 005696208 |
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