OrganizationActive
Panacea Brain and Spine, LLC
NPI 1154765121 · Non-Pharmacy Dispensing Site · Lake Havasu City, AZ
Provider details
- NPI number
- 1154765121
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Panacea Brain and Spine, LLC
- Authorized official
- Chad Hartley, Owner
Practice location
297 Lake Havasu Ave S
Suite 204
Lake Havasu City, AZ 86403-6526
Phone: (928) 453-2211
Mailing address
2980 N Beverly Glen Cir
Los Angeles, CA 90077-1726
Registry dates
- Enumerated
- 2013-04-22
- Last updated
- 2013-04-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.