MEDICARE: ATLAS CHIROPRACTIC SERVICES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X007300-1	NY

General Provider Information

NPI Number	:	1013189430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS CHIROPRACTIC SERVICES, P.C.

Provider Business Mailing Address
First Line	:	141 SHOP CITY PLZ
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13206-1943
Country	:	US
Telephone Number	:	315-414-0224
Fax Number	:	315-414-0396

Provider Business Practice Location Address
First Line	:	141 SHOP CITY PLZ
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13206-1943
Country	:	US
Telephone Number	:	315-414-0224
Fax Number	:	315-414-0396

Authorized Official
Title or Position	:	CHIRO ASSISTANT
Name	:	DANIELLE POKORNEY
Credential	:
Telephone Number	:	315-463-4641

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	01/14/2009

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