Healthcare Provider Details

I. General information

NPI: 1144176256
Provider Name (Legal Business Name): ATLAS HEALTH IOWA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12345 BEACH BLVD APT 537
STANTON CA
90680-4110
US

IV. Provider business mailing address

12345 BEACH BLVD APT 537
STANTON CA
90680-4110
US

V. Phone/Fax

Practice location:
  • Phone: 386-444-9409
  • Fax:
Mailing address:
  • Phone: 386-444-9409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIONEL WRIGHT
Title or Position: OWNER
Credential: PA-C
Phone: 386-444-9409