| Name: | Coastal Physical Medicine, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 04 Jun 2012 (12 years ago) |
| Date of dissolution: | 17 Mar 2014 |
| Entity Number: | 000-060-923 |
| Register Number: | 000060923 |
| Historical Names: |
Back on Track Physical Medicine, Inc.
|
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 1600 N MCKENZIE STFOLEY, AL 36535 |
| Principal Address ZIP Code: | 36535 |
| Authorized Capital: | 1000 @ $.01 PV |
Activities
PRACTICE OF ANY BRANCH OF THE HEALING ARTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407290695 | 2013-04-18 | 2013-08-14 | 1600 N MCKENZIE ST, FOLEY, AL, 365352248, US | 1600 N MCKENZIE ST, FOLEY, AL, 365352248, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 251-955-2225 |
| Fax | 2519801945 |
Authorized person
| Name | DR. RICHARD RIZZUTO |
| Role | PRESIDENT |
| Phone | 2519552225 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 24538 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RIZZUTO, RICHARD | Agent | 1600 N MCKENZIE STFOLEY, AL 36535 |
| Name | Role | Address |
|---|---|---|
| RIZZUTO, RICHARD | Director | 1600 N MCKENZIE STFOLEY, AL 36535 |
| Name | Role | Address |
|---|---|---|
| MEYER, ALBERT R | Incorporator | 1340 PIAZZA PITTIBOYNTON BEACH, FL 33426 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-04-18 | Name Change | Back on Track Physical Medicine, Inc. | Coastal Physical Medicine, Inc. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
