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General NPI Number Information
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NPI Number | 1629427398
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Entity Type | Organization
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Legal Business Name | ATLAS CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 1322 S MAIN ST
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City | EATON RAPIDS
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State | MI
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Zip | 48827-1921
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Country | US
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Telephone | 517-281-4566
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Fax | 517-663-7061
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Provider Business Mailing Address
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Address Line | 1322 S MAIN ST
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City | EATON RAPIDS
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State | MI
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Zip | 48827-1921
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Country | US
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Telephone | 517-281-4566
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Fax | 517-663-7061
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Authorized Official
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Title or Position | OWNER CHIROPRACTOR
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Name | DR. DIANN GAIL PARKER
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Credential | D.C.
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Telephone | 517-663-7060
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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 | 1093752644
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1710924360
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License Number State | MI
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