Healthcare Provider Details

I. General information

NPI: 1003975574
Provider Name (Legal Business Name): ALLIANCE HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 LAWRENCEVILLE SUWANEE ROAD SUITE 1C
SUWANEE GA
30024
US

IV. Provider business mailing address

3320 LAWRENCEVILLE SUWANEE ROAD SUITE 1C
SUWANEE GA
30024
US

V. Phone/Fax

Practice location:
  • Phone: 678-714-5722
  • Fax: 678-714-5724
Mailing address:
  • Phone: 678-714-5722
  • Fax: 678-714-5724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIRO007116
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIRO006264
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberGA11414
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberGA6920
License Number StateGA

VIII. Authorized Official

Name: ABDO IBRAHIM
Title or Position: CO OWNER
Credential: DC
Phone: 678-714-5722