NPI 1154765121
Panacea Brain and Spine, LLC
Practice location
- Address
- 297 Lake Havasu Ave S Suite 204, Lake Havasu City, AZ 86403-6526
- Phone
- (928) 453-2211
- Mailing address
- 2980 N Beverly Glen Cir Suite 301, Los Angeles, CA 90077-1726
Authorised official
- Name
- Chad E. Hartley
- Title
- Owner
- Phone
- (928) 453-2211
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1154765121
- Entity type
- Organization
- NPI issued
- 22 Apr 2013
- Record last updated
- 22 Apr 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.