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General NPI Number Information
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NPI Number | 1316826969
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Entity Type | Organization
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Legal Business Name | ALTERNATE HEALTH CLUB LLC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1309 COFFEEN AVE # 1200
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City | SHERIDAN
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State | WY
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Zip | 82801-5777
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Country | US
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Telephone | 631-647-0162
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 COFFEEN AVE
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City | SHERIDAN
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State | WY
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Zip | 82801-5777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | NAUMAN ALI SHAHID
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Credential |
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Telephone | 646-371-4498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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