Healthcare Provider Details

I. General information

NPI: 1205175551
Provider Name (Legal Business Name): ATLANTIS GLOBAL RESEARCH INSTITUTE, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11124 W CALIFORNIA AVE STE G
YOUNGTOWN AZ
85363-1246
US

IV. Provider business mailing address

11124 W CALIFORNIA AVE STE G
YOUNGTOWN AZ
85363-1246
US

V. Phone/Fax

Practice location:
  • Phone: 602-432-8813
  • Fax:
Mailing address:
  • Phone: 602-432-8813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name: DAVID TOWNS
Title or Position: OWNER
Credential: M.D.
Phone: 602-432-8813