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General NPI Number Information
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NPI Number | 1124567847
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Entity Type | Organization
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Legal Business Name | ATLAS CHIROPRACTIC
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 1305 SW LOOP 410 SUITE 227
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City | SAN ANTONIO
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State | TX
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Zip | 78227-1610
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Country | US
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Telephone | 210-670-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 8410 FOUNTAIN CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2387
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN TRAVIS
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Credential | D.C.
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Telephone | 210-308-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 138182
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License Number State | TX
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