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General NPI Number Information
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NPI Number | 1891865366
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Entity Type | Organization
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Legal Business Name | ALLIANCE NEUROLOGICAL CENTER INC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1914 S UNION AVE
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City | ALLIANCE
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State | OH
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Zip | 44601-4355
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Country | US
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Telephone | 330-829-9389
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Fax | 330-829-9372
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Provider Business Mailing Address
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Address Line | 270 E STATE ST SUITE 140
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City | ALLIANCE
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State | OH
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Zip | 44601-4957
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Country | US
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Telephone | 330-823-4044
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Fax | 330-829-9372
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Authorized Official
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Title or Position | CONTRACT CREDENTIALING
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Name | CAROL E KLINE
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Credential |
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Telephone | 330-829-9389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35047526S
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License Number State | OH
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