Organization
ATLAS MEDICAL ACO LLC
Active
Parent organization
ATLAS MEDICAL ACO LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLAS MEDICAL ACO LLC
Authorized official
GREGORY CHAD MANGUM (OWNER)
(435) 514-5646
Entity
Organization
Contact information
Practice address
3831 E BLUE LUPINE DR STE C, WASILLA, AK 99654-8461
(907) 521-2368
Mailing address
PO BOX 4682, LOGAN, UT 84323-4682
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
10/17/2024
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