Healthcare Provider Details

I. General information

NPI: 1215017173
Provider Name (Legal Business Name): ATLAS FAMILY CHIROPRACTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 HOSPITAL DRIVE
TAPPAHANNOCK VA
22560-2667
US

IV. Provider business mailing address

PO BOX 1830
TAPPAHANNOCK VA
22560-1830
US

V. Phone/Fax

Practice location:
  • Phone: 804-443-6967
  • Fax: 804-443-4938
Mailing address:
  • Phone: 804-443-6967
  • Fax: 804-443-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN F SHIELDS
Title or Position: BILLING MANAGER
Credential:
Phone: 804-282-9133