Organization · NPI-2

Atlas Chiropractic Of Fort Wayne LLC

Clinic/Center · Fort Wayne, IN

NPI number1396428355
StatusActive
Last updated in NPPESAug 8, 2023

Details

NPI
1396428355
Entity type
Organization (NPI-2)
Legal business name
Atlas Chiropractic Of Fort Wayne LLC
Organization subpart
No
Enumeration date
Aug 8, 2023
Certification date
Aug 8, 2023
Last updated
Aug 8, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

5113 N Bend Dr
Fort Wayne, IN 46804-1753

Phone 260-399-9020 · Fax 260-399-9020

Mailing address

5113 N Bend Dr
Fort Wayne, IN 46804-1753

Phone 260-399-9020 · Fax 260-399-9020

Authorized official

Emily Darr Staples
Owner
4196038605

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