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Organization
HEALTH ATLAST POCATELLO LLC
Active
Organization
HEALTH ATLAST POCATELLO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHALOAM AGALELEI OFISA D.C., M.S. (OWNER)
(208) 242-3723
Entity
Organization
Contact information
Practice address
1800 FLANDRO DR STE 110, POCATELLO, ID 83202-4936
(208) 242-3723
(208) 904-1052
Mailing address
1800 FLANDRO DR STE 110, POCATELLO, ID 83202-4936
(208) 242-3723
(208) 904-1052
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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