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General NPI Number Information
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NPI Number | 1841178563
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Entity Type | Organization
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Legal Business Name | ERCANBRACK SURGICAL PC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 34169 US HIGHWAY 2 STE 3
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City | LIBBY
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State | MT
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Zip | 59923-8430
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Country | US
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Telephone | 406-405-2112
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Fax | 406-405-3113
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Provider Business Mailing Address
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Address Line | 34169 US HIGHWAY 2 STE 3
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City | LIBBY
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State | MT
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Zip | 59923-8430
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Country | US
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Telephone | 406-283-1232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LANCE L ERCANBRACK
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Credential | MD
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Telephone | 406-283-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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