Provider Demographics
NPI:1891008967
Name:ALLIANCE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ALLIANCE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:423-240-0512
Mailing Address - Street 1:2020 GUNBARREL RD.
Mailing Address - Street 2:SUITE 408
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2663
Mailing Address - Country:US
Mailing Address - Phone:423-238-1127
Mailing Address - Fax:423-238-1277
Practice Address - Street 1:283 PAUL HUFF PKWY NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2967
Practice Address - Country:US
Practice Address - Phone:423-648-5103
Practice Address - Fax:423-648-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1517399Medicare UPIN