Organization
ADVANCE NEUROLOGY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL PACKARD MD (OWNER)
(888) 395-4007
Entity
Organization
Contact information
Practice address
38 RAMBLING RD, PALESTINE, TX 75801-4666
(888) 395-4007
Mailing address
21218 SAINT ANDREWS BLVD # 529, BOCA RATON, FL 33433-2435
(888) 395-4007
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
L5082
TX
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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