Organization
ALLIANCE PHYSICIAN INC
Active
Parent organization
ALLIANCE PHYSICIANS, INC
Other names
Kettering Sports Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLIANCE PHYSICIANS, INC
Authorized official
TIMOTHY Y KO (CFO)
(937) 558-3223
Entity
Organization
Contact information
Practice address
4403 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 395-3920
(937) 395-3940
Mailing address
1 PRESTIGE PL, SUITE 550, MIAMISBURG, OH 45342-3794
(937) 762-1305
(937) 522-7513
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864833
—
OH
Enumeration date
11/14/2006
Last updated
10/04/2019
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