Healthcare Provider Details

I. General information

NPI: 1316993512
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE SERVICES OF GEORGIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US

IV. Provider business mailing address

2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US

V. Phone/Fax

Practice location:
  • Phone: 561-244-0220
  • Fax: 561-244-0222
Mailing address:
  • Phone: 561-244-0220
  • Fax: 561-244-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES M DOUTHITT
Title or Position: CFO
Credential:
Phone: 561-244-3603