MEDICARE: ALLIANCE THERAPIES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center	SP-2013	NV

General Provider Information

NPI Number	:	1720525371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE THERAPIES, PLLC

Provider Business Mailing Address
First Line	:	3009 W CHARLESTON BLVD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1943
Country	:	US
Telephone Number	:	702-831-6670
Fax Number	:

Provider Business Practice Location Address
First Line	:	3009 W CHARLESTON BLVD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1943
Country	:	US
Telephone Number	:	702-831-6670
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	ADRIENNE WILLIAMS
Credential	:	MS, CCC-SLP
Telephone Number	:	702-831-6670

Provider Enumeration Date	:	01/20/2017
Last Update Date	:	01/20/2017

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