Provider Demographics
NPI:1851748727
Name:ATLAS CHIROPRACTIC CENTER @ BRIARGATE INC
Entity Type:Organization
Organization Name:ATLAS CHIROPRACTIC CENTER @ BRIARGATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-278-3612
Mailing Address - Street 1:9362 GRAND CORDERA PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-7009
Mailing Address - Country:US
Mailing Address - Phone:719-278-3612
Mailing Address - Fax:719-278-3614
Practice Address - Street 1:9362 GRAND CORDERA PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-7009
Practice Address - Country:US
Practice Address - Phone:719-278-3612
Practice Address - Fax:719-278-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty