Provider Demographics
NPI:1205019593
Name:ATLAS HEALTH, P.C.
Entity Type:Organization
Organization Name:ATLAS HEALTH, P.C.
Other - Org Name:ATLAS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-223-9775
Mailing Address - Street 1:1903 WILMINGTON DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6100
Mailing Address - Country:US
Mailing Address - Phone:970-223-8775
Mailing Address - Fax:
Practice Address - Street 1:1417 CANAL DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5812
Practice Address - Country:US
Practice Address - Phone:303-539-6919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801403Medicare PIN