Provider Demographics
NPI:1811384803
Name:ATLAS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:ATLAS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DR. JAMES
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:SHEFFER
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:816-353-9040
Mailing Address - Street 1:4621 S SHRANK DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5453
Mailing Address - Country:US
Mailing Address - Phone:816-353-9040
Mailing Address - Fax:816-353-0091
Practice Address - Street 1:4621 S SHRANK DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5453
Practice Address - Country:US
Practice Address - Phone:816-353-9040
Practice Address - Fax:816-353-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011000714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA3942Medicare PIN