Organization
PANACEA BRAIN AND SPINE, LLC
Active
Organization
PANACEA BRAIN AND SPINE, LLC
Active
Parent organization
PANACEA BRAIN AND SPINE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PANACEA BRAIN AND SPINE, LLC
Authorized official
DR. CHAD E. HARTLEY MD (OWNER)
(928) 453-2211
Entity
Organization
Contact information
Practice address
297 LAKE HAVASU AVE S, SUITE 204, LAKE HAVASU CITY, AZ 86403-6526
(928) 453-2211
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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