OrganizationActive
Head Sport Em LLC
NPI 1194598102 · Sports Medicine (Family Medicine) Physician · Coeur D Alene, ID
Provider details
- NPI number
- 1194598102
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Craig Panos, Owner(208) 512-4334
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
980 W Ironwood Dr Ste 206
Coeur D Alene, ID 83814-2668
Phone: (208) 512-4334
Approximate (ZIP-level) locationGet directions
Mailing address
980 W Ironwood Dr Ste 206
Coeur D Alene, ID 83814-2668
Other names (DBA / former)
- Doing business as
- Head Spine Sport
Registry dates
- Enumerated
- 2023-11-01
- Last updated
- 2023-11-01
- Certified
- 2023-11-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.