Atlas Medical Aco LLC

NPI #1790513109 in Logan, Utah

Provider Information

NPI Number: 1790513109
Entity Type: Organization
Organization Name: Atlas Medical Aco LLC
Primary Specialty: Clinic/Center
Enumeration Date: Jul 25, 2024
Last Updated: Oct 17, 2024

Practice Location

Address: 258 S MAIN ST STE 210
City: Logan
State: Utah
ZIP Code: 84321-5768
Phone: (435) 999-9510

Authorized Official

Name: GREGORY CHAD MANGUM
Title: OWNER
Phone: (435) 514-5646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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