Individual
JOEL PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
50 PINE DEL DR, FLAGSTAFF, AZ 86005-9603
(928) 699-6786
Mailing address
50 PINE DEL DR, FLAGSTAFF, AZ 86005-9603
(928) 699-6786
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/18/2015
Last updated
08/15/2015
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