Provider Demographics
NPI:1467725549
Name:ATLAS CLINIC LLC
Entity Type:Organization
Organization Name:ATLAS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUEL-HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC BC AO
Authorized Official - Phone:770-545-8150
Mailing Address - Street 1:2810 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:STE# E
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8176
Mailing Address - Country:US
Mailing Address - Phone:770-545-8150
Mailing Address - Fax:770-545-8151
Practice Address - Street 1:3288 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341
Practice Address - Country:US
Practice Address - Phone:770-457-4430
Practice Address - Fax:770-454-8328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty