Healthcare Provider Details

I. General information

NPI: 1497977938
Provider Name (Legal Business Name): ALLIANCE HEALTH AND WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ATLANTA RD
CUMMING GA
30040-2609
US

IV. Provider business mailing address

233 ATLANTA RD
CUMMING GA
30040-2609
US

V. Phone/Fax

Practice location:
  • Phone: 770-888-4600
  • Fax: 770-888-4601
Mailing address:
  • Phone: 770-888-4600
  • Fax: 770-888-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCHIR005583
License Number StateGA

VIII. Authorized Official

Name: DR. BRIAN JON RUGGIERO
Title or Position: OWNER
Credential: D.C.
Phone: 770-888-4600