Provider Demographics
NPI:1235325887
Name:ATLAS CHIROPRACTIC LTD LLC
Entity Type:Organization
Organization Name:ATLAS CHIROPRACTIC LTD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-268-2260
Mailing Address - Street 1:100 E LEE RD STE B
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-3267
Mailing Address - Country:US
Mailing Address - Phone:864-268-2260
Mailing Address - Fax:864-268-5424
Practice Address - Street 1:100 E LEE RD STE B
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-3267
Practice Address - Country:US
Practice Address - Phone:864-268-2260
Practice Address - Fax:864-268-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH0797Medicaid
1184658700OtherNPI
SCT816248863Medicare UPIN
SC8863Medicare UPIN