Provider Demographics
NPI:1669830253
Name:ATLAS WELLNESS LLC
Entity Type:Organization
Organization Name:ATLAS WELLNESS LLC
Other - Org Name:UPPER CERVICAL HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RION
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-862-5355
Mailing Address - Street 1:7001 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 332
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3604
Mailing Address - Country:US
Mailing Address - Phone:248-862-5355
Mailing Address - Fax:
Practice Address - Street 1:7001 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 332
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3604
Practice Address - Country:US
Practice Address - Phone:248-862-5355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty