Provider Demographics
NPI:1215017173
Name:ATLAS FAMILY CHIROPRACTIC, INC
Entity type:Organization
Organization Name:ATLAS FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-282-9133
Mailing Address - Street 1:PO BOX 1830
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-1830
Mailing Address - Country:US
Mailing Address - Phone:804-443-6967
Mailing Address - Fax:804-443-4938
Practice Address - Street 1:281 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560-2667
Practice Address - Country:US
Practice Address - Phone:804-443-6967
Practice Address - Fax:804-443-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09153Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
C09153Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER