Healthcare Provider Details

I. General information

NPI: 1962822239
Provider Name (Legal Business Name): ATLAS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 DOWNTOWN WEST BLVD STE B
KNOXVILLE TN
37919-5408
US

IV. Provider business mailing address

PO BOX 24683
KNOXVILLE TN
37933-2683
US

V. Phone/Fax

Practice location:
  • Phone: 865-333-4844
  • Fax:
Mailing address:
  • Phone: 865-333-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT0000005104
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AMIT PATEL
Title or Position: MANAGER
Credential:
Phone: 865-333-4844