Organization
LARRY L PACK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY L PACK M.D. (OWNER)
(810) 750-5800
Entity
Organization
Contact information
Practice address
2420 OWEN RD, STE C, FENTON, MI 48430-3417
(810) 750-5800
(810) 750-5809
Mailing address
9362 WARWICK MDWS, PO BOX 590, GRAND BLANC, MI 48439-9552
(810) 750-5800
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301035400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4940460
—
MI
Enumeration date
10/21/2006
Last updated
04/15/2010
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