Organization
ATLAS MEDICAL ACO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CHAD MANGUM (OWNER)
(435) 514-5646
Entity
Organization
Contact information
Practice address
258 S MAIN ST STE 210, LOGAN, UT 84321-5768
(435) 999-9510
Mailing address
258 S MAIN ST STE 210, LOGAN, UT 84321-5768
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
10/17/2024
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