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NPI Code Detail

MEDICARE: ATLAS SPINAL CARE

MEDICARE: ATLAS SPINAL CARE
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
1111N00000XChiropractorWI

General Provider Information

NPI Number : 1861916769
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLAS SPINAL CARE
Provider Business Mailing Address
First Line : 2069 CENTRAL CT STE 11
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-4281
Country : US
Telephone Number : 920-241-6808
Fax Number :
Provider Business Practice Location Address
First Line : 2069 CENTRAL CT
Second Line : SUITE 11
City : GREEN BAY
State : WI
Zip : 54311
Country : US
Telephone Number : 920-241-6808
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. TYLER ALLEN MALUEG
Credential : DC
Telephone Number : 920-851-4551
Provider Enumeration Date : 08/01/2017
Last Update Date : 07/21/2022

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Directions to “ATLAS SPINAL CARE ” Practice Location

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