Provider Demographics
NPI:1871865998
Name:ATLAS CLINIC OF CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ATLAS CLINIC OF CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SNYDER PLOCEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-940-2262
Mailing Address - Street 1:1010 S CASCADE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4980
Mailing Address - Country:US
Mailing Address - Phone:970-252-0378
Mailing Address - Fax:
Practice Address - Street 1:1010 S CASCADE AVE STE A
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4980
Practice Address - Country:US
Practice Address - Phone:970-252-0378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-05
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6773111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty