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ACCIDENT SPINE & REHAB, INC.

Details

Name: ACCIDENT SPINE & REHAB, INC.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 08 Mar 2012 (13 years ago) (Companies founded in March 2012)
Entity Number: 000-044-482
Register Number: 000044482
ZIP code: 35406 (Companies in Tuscaloosa, 35406)
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Registered Office Street Address: 5945 KNIGHT AVENUETUSCALOOSA, AL 35406
Authorized Capital: 10,000 @ $1 PV

Activities ENGAGE IN MULTIPLE DISCIPLINARY SPINAL CARE/REHABILITATION

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1649691858 2013-12-16 2015-08-20 819 MIMOSA PARK RD, TUSCALOOSA, AL, 354054839, US 1401 3RD AVE W, SUITE 108, BIRMINGHAM, AL, 352085300, US

Contacts

Phone +1 205-561-6015
Fax 2059576740

Authorized person

Name DR. BRENT ALAN TIDWELL
Role PRESIDENT
Phone 2055616015

Taxonomy

Taxonomy Code 111NR0400X - Rehabilitation Chiropractor
License Number 2100
State AL
Is Primary Yes

Agent

Name Role Address
TIDWELL, BRENT Agent 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405

Incorporator

Name Role Address
TIDWELL, BRENT Incorporator 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405

Director

Name Role Address
TIDWELL, BRENT Director 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State