ADHD CLINICS OF ARIZONA
Ambulatory Health at University Ave, Flagstaff, AZ

License number
Arizona 3125
Category
Ambulatory Health
Type
Adolescent and Children Mental Health
Owner
Name: DR. BRUCE PACKARD ED.D., PC
Title: PARTNER
Phone: (928) 773-7774
Address
Address
1016 W University Ave, Flagstaff, AZ 86001
National Provider ID: 1649403544
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ADHD CLINICS OF ARIZONA, P.L.L.C

1006 W Elizabeth Rd, Flagstaff, AZ 86001

Registration:
Sep 20, 2011
State ID:
P-1709043-8
Expiration:
PERPETUAL
Members:
Angela L Keith (Member), 1016 W University Ave #202, Flagstaff, AZ 86001 (Physical),Heather Nash (Member), 1016 W University Ave #202, Flagstaff, AZ 86001 (Physical)
Agent:
Taylor R Nelson,219 N Humphreys, Flagstaff, AZ 86001 (Physical)

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