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General NPI Number Information
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NPI Number | 1356481568
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Entity Type | Organization
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Legal Business Name | ALLIANCE LONG TERM CARE CONSULTING, LLC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3720 W PARRISH AVE
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City | OWENSBORO
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State | KY
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Zip | 42301-3325
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Country | US
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Telephone | 270-993-2841
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 W PARRISH AVE
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City | OWENSBORO
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State | KY
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Zip | 42301-3325
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Country | US
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Telephone | 270-993-2841
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT MEMBER
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Name | DR. MARTY SHANE TRAYLOR
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Credential | O.D.
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Telephone | 270-993-2841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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