Provider Demographics
NPI:1982118345
Name:ATLAS PT
Entity Type:Organization
Organization Name:ATLAS PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-520-9070
Mailing Address - Street 1:625 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1038
Mailing Address - Country:US
Mailing Address - Phone:419-520-9070
Mailing Address - Fax:419-520-9071
Practice Address - Street 1:625 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1038
Practice Address - Country:US
Practice Address - Phone:419-520-9070
Practice Address - Fax:419-520-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy