Organization
HEAD SPORT EM LLC
Active
Other names
Head Spine Sport
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG PANOS MD (OWNER)
(208) 512-4334
Entity
Organization
Contact information
Practice address
980 W IRONWOOD DR STE 206, COEUR D ALENE, ID 83814-2668
(208) 512-4334
Mailing address
980 W IRONWOOD DR STE 206, COEUR D ALENE, ID 83814-2668
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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