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General NPI Number Information
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NPI Number | 1336762400
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Entity Type | Organization
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Legal Business Name | ATOA BRANDS, PLLC
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Dates
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Enumeration Date | 05/24/2020
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Last Update Date | 05/24/2020
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Provider Practice Location Address
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Address Line | 8846 S REDWOOD RD STE N103
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City | WEST JORDAN
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State | UT
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Zip | 84088-4701
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Country | US
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Telephone | 801-255-0665
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Fax |
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Provider Business Mailing Address
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Address Line | 6337 W HERITAGE HILL DR
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City | HERRIMAN
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State | UT
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Zip | 84096-7790
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Country | US
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Telephone | 214-960-0700
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TYLER S TAUMOLI
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Credential | DC
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Telephone | 801-255-0665
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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 |
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License Number State |
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