NPI 1457622763

Panacea Brain and Spine, LLC

Organisation Neurological Surgery Physician Lake Havasu City, AZ

Practice location

Address: 72 Lake Havasu Ave S STE 102, Lake Havasu City, AZ 86403-0857
Phone: (928) 453-2211
Fax: (928) 453-2213

Authorised official

Name: Chad Hartley
Title: Owner
Phone: (720) 883-1593

Registered specialties

Neurological Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207T00000X Licence 46605 (AZ)

Other Neurological Surgery providers in Arizona →

Registry record

NPI: 1457622763
Entity type: Organization
NPI issued: 18 Jan 2012
Record last updated: 29 Jun 2020

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.