Healthcare Provider Details

I. General information

NPI: 1770274540
Provider Name (Legal Business Name): ALLIANCE PERSONALIZED HEALTH CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N EAGLE CREEK DR STE 410
LEXINGTON KY
40509-1894
US

IV. Provider business mailing address

151 N EAGLE CREEK DR STE 410
LEXINGTON KY
40509-1894
US

V. Phone/Fax

Practice location:
  • Phone: 859-469-4534
  • Fax:
Mailing address:
  • Phone: 859-469-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CLAIR E PALLEY
Title or Position: OWNER
Credential: MD
Phone: 859-469-4534