Healthcare Provider Details

I. General information

NPI: 1114880986
Provider Name (Legal Business Name): ATLAS PERFORMANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 OAK CREEK DR
DAWSONVILLE GA
30534-7017
US

IV. Provider business mailing address

247 OAK CREEK DR
DAWSONVILLE GA
30534-7017
US

V. Phone/Fax

Practice location:
  • Phone: 678-640-4191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ALEX ANNIS
Title or Position: CEO
Credential: DC
Phone: 678-640-4191