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General NPI Number Information
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NPI Number | 1316422587
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Entity Type | Organization
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Legal Business Name | ATLAS INJURY REHAB CENTER LLC
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 6164 N US HIGHWAY 41
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City | APOLLO BEACH
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State | FL
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Zip | 33572-1806
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Country | US
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Telephone | 813-645-1130
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Fax | 813-645-1132
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Provider Business Mailing Address
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Address Line | 6164 N US HIGHWAY 41
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City | APOLLO BEACH
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State | FL
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Zip | 33572-1806
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Country | US
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Telephone | 813-645-1130
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Fax | 813-645-1132
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Authorized Official
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Title or Position | REGISTERED AGENT/ MANAGER
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Name | MRS. MARY ANN PECINA
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Credential |
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Telephone | 813-645-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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