# MISSOURI GATEWAY HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALLYALIGN HEALTH, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073052114
- **Legal business name:** ALLYALIGN HEALTH, INC
- **Authorized official:** KENNETH BRATTON (COO)
- **Authorized official phone:** (804) 396-6412

## Contact information

- **Practice address:** 10900 NUCKOLS RD, STE 110, GLEN ALLEN, VA 23060-9276
- **Practice address phone:** (804) 396-6412
- **Practice address fax:** (804) 482-2756
- **Mailing address:** 10900 NUCKOLS RD, SUITE 110, GLEN ALLEN, VA 23060-9276
- **Mailing address phone:** (804) 396-6412
- **Mailing address fax:** (804) 482-2756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/22/2017
- **Last updated:** 02/22/2017