Individual
RICHARD E PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
(330) 332-7663
Mailing address
3622 BELMONT AVE, SUITE 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-114377331
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
NA-01763
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0748025
—
OH
Enumeration date
05/26/2006
Last updated
03/23/2011
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