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General NPI Number Information
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NPI Number | 1346740230
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Entity Type | Organization
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Legal Business Name | ALLIANCE HEALTH CARE INC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 3545 CRUSE RD STE 103
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3169
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Country | US
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Telephone | 770-456-5666
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Fax | 770-456-5726
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Provider Business Mailing Address
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Address Line | 3545 CRUSE RD STE 103
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3169
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Country | US
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Telephone | 770-456-5666
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Fax | 770-456-5726
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Authorized Official
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Title or Position | MANAGER
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Name | SHARON SELENA DUNCAN
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Credential |
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Telephone | 205-588-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 66399
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License Number State | GA
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