Provider Demographics
NPI:1659728871
Name:ALLIANCE EVALUATION SERVICES LLC
Entity Type:Organization
Organization Name:ALLIANCE EVALUATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:OMALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-209-7869
Mailing Address - Street 1:18631 N 19TH AVE STE 158458
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-0414
Mailing Address - Country:US
Mailing Address - Phone:623-209-7869
Mailing Address - Fax:
Practice Address - Street 1:10586 W COTTONTAIL LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-9660
Practice Address - Country:US
Practice Address - Phone:623-209-7869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZL15882468OtherINDEPENDENT MEDICAL EXAMINATION - WORKERS COMP