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General NPI Number Information
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NPI Number | 1346993011
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Entity Type | Organization
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Legal Business Name | ATOLOGIX HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 3262 STADIUM DR
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City | KALAMAZOO
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State | MI
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Zip | 49008-1527
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Country | US
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Telephone | 269-367-2737
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Fax |
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Provider Business Mailing Address
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Address Line | 3262 STADIUM DR
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City | KALAMAZOO
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State | MI
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Zip | 49008-1527
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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 | DIRECTOR
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Name | MR. OMAR AZAM
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Credential |
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Telephone | 269-873-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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