Provider Demographics
NPI:1053788687
Name:ALLIANCE VENTURES
Entity type:Organization
Organization Name:ALLIANCE VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-348-2940
Mailing Address - Street 1:340 S 33RD ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-5036
Mailing Address - Country:US
Mailing Address - Phone:918-348-2940
Mailing Address - Fax:888-588-4381
Practice Address - Street 1:340 S 33RD ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-5036
Practice Address - Country:US
Practice Address - Phone:918-348-2940
Practice Address - Fax:888-588-4381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy