Provider Demographics
NPI:1114670064
Name:ATLAS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ATLAS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-655-7972
Mailing Address - Street 1:1855 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2426
Mailing Address - Country:US
Mailing Address - Phone:617-533-8902
Mailing Address - Fax:617-533-7814
Practice Address - Street 1:157 ESSEX STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840000
Practice Address - Country:US
Practice Address - Phone:978-655-7972
Practice Address - Fax:978-655-5414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty