| Alliance Family Practice, P.c. | |
|
40 Liberty St Petersburg VA 23803-5021 | |
| (804) 862-2878 | |
| (804) 862-2879 |
| Full Name | Alliance Family Practice, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 40 Liberty St, Petersburg, Virginia |
| Authorized Official Name and Position | Zelda West Johnson (FAMILY PRACTICE PROVIDER) |
| Authorized Official Contact | 8048622878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Family Practice, P.c. 40 Liberty St Petersburg VA 23803-5021 Ph: (804) 862-2878 | Alliance Family Practice, P.c. 40 Liberty St Petersburg VA 23803-5021 Ph: (804) 862-2878 |
| NPI Number | 1174714141 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 06/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174714141 | NPI | - | NPPES |
| 302200 | Other | VA | ANTHEM BC OF VIRGINIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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