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RENEW REHAB AND WELLNESS, LLC

Details

Name: RENEW REHAB AND WELLNESS, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 22 Jun 2012 (12 years ago)
Entity Number: 000-064-619
Register Number: 000064619
County: Fayette
Place of Formation: Fayette County
Registered Office Street Address: 2005 PINEVIEW CIRCLE NWFAYETTE, AL 35555
Registered Office Street Address ZIP Code: 35555

Activities PHYSICAL REHABILITATIVE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851715890 2014-02-11 2014-02-11 PO BOX 1641, VERNON, AL, 355921641, US 314 COLUMBUS AVE NW, VERNON, AL, 355925703, US

Contacts

Phone +1 205-695-5111
Fax 2056955110

Authorized person

Name MR. JAMES KERRY RICHARDSON
Role OWNER
Phone 2056955111

Taxonomy

Taxonomy Code 225100000X - Physical Therapist
License Number PTH2757
State AL
Is Primary Yes

Organizer

Name Role Address
RICHARDSON, JAMES KERRY Organizer 2005 PINEVIEW CIRCLE NWFAYETTE, AL 35555

Agent

Name Role
RICHARDSON, JAMES K Agent

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State