# ATLAS SPECIFIC SPINE CENTER LLC

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

## Provider details

- **NPI number:** 1356902407
- **Authorized official:** TATE GENTILE (OFFICER)
- **Authorized official phone:** (808) 498-0295

## Contact information

- **Practice address:** 65-1184 MAMALAHOA HWY, KAMUELA, HI 96743-8431
- **Practice address phone:** (719) 351-6099
- **Mailing address:** 65-1184 MAMALAHOA HWY, KAMUELA, HI 96743-8431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2019
- **Last updated:** 11/05/2020