| Havasu Neurological Center Pllc | |
|
297 Lake Havasu Ave S Suite 106 Lake Havasu City AZ 86403-6526 | |
| (928) 680-4040 | |
| (928) 680-4484 |
| Full Name | Havasu Neurological Center Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 297 Lake Havasu Ave S, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Maame A Dankwah-quansah (OWNER/MEMBER) |
| Authorized Official Contact | 9286804040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Havasu Neurological Center Pllc 297 Lake Havasu Ave S Suite 106 Lake Havasu City AZ 86403-6526 Ph: (928) 680-4040 | Havasu Neurological Center Pllc 297 Lake Havasu Ave S Suite 106 Lake Havasu City AZ 86403-6526 Ph: (928) 680-4040 |
| NPI Number | 1063849388 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 03/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063849388 | NPI | - | NPPES |
| P-1875159-0 | Other | AZ | CORPORATION NUMBER |
| 872509 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Arizona) | Primary |
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