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General NPI Number Information
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NPI Number | 1710392691
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Entity Type | Organization
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Legal Business Name | ATLAS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 185 MAIN ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-3032
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Country | US
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Telephone | 203-466-1111
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Fax | 203-468-9684
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Provider Business Mailing Address
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Address Line | 185 MAIN ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-3032
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Country | US
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Telephone | 203-466-1111
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Fax | 203-468-9684
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADAM ROY CHURCH
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Credential | D.C.
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Telephone | 203-466-1111
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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 | 001459
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License Number State | CT
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