| Atlas Medical Aco LLC | |
|
258 S Main St Ste 210 Logan UT 84321-5768 | |
| (435) 999-9510 | |
| Not Available |
| Full Name | Atlas Medical Aco LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 258 S Main St Ste 210, Logan, Utah |
| Authorized Official Name and Position | Gregory Chad Mangum (OWNER) |
| Authorized Official Contact | 4355145646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlas Medical Aco LLC 258 S Main St Ste 210 Logan UT 84321-5768 | Atlas Medical Aco LLC 258 S Main St Ste 210 Logan UT 84321-5768 Ph: (435) 999-9510 |
| NPI Number | 1790513109 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790513109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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