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General NPI Number Information
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NPI Number | 1770818148
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Entity Type | Organization
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Legal Business Name | ATLAS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 07/21/2017
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Provider Practice Location Address
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Address Line | 24 E GRINNELL PLZ
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City | SHERIDAN
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State | WY
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Zip | 82801-3936
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Country | US
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Telephone | 307-672-6000
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Fax | 307-673-0970
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Provider Business Mailing Address
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Address Line | 24 E GRINNELL PLZ
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City | SHERIDAN
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State | WY
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Zip | 82801-3936
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Country | US
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Telephone | 307-672-6000
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Fax | 307-673-0970
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. COLIN HARDY
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Credential | D.C.
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Telephone | 307-672-6000
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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 | 695
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License Number State | WY
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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 | 728
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License Number State | WY
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