# HEALTH ATLAST POCATELLO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235789249
- **Authorized official:** DR. SHALOAM AGALELEI OFISA D.C., M.S. (OWNER)
- **Authorized official phone:** (208) 242-3723

## Contact information

- **Practice address:** 1800 FLANDRO DR STE 110, POCATELLO, ID 83202-4936
- **Practice address phone:** (208) 242-3723
- **Practice address fax:** (208) 904-1052
- **Mailing address:** 1800 FLANDRO DR STE 110, POCATELLO, ID 83202-4936
- **Mailing address phone:** (208) 242-3723
- **Mailing address fax:** (208) 904-1052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 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