| Name: | West Mobile Chiropractic, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 03 Nov 1988 (36 years ago) |
| Entity Number: | 000-127-202 |
| Register Number: | 000127202 |
| Historical Names: |
West Mobile Chiropractic, P.C.
Youngblood Chiropractic, P.C. |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 7765 AIRPORT BLVD SUITE 807MOBILE, AL 36608 |
| Registered Office Street Address ZIP Code: | 36608 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1356495378 | 2007-01-23 | 2008-03-12 | 260 CODY RD S, MOBILE, AL, 366953408, US | 260 CODY RD S, MOBILE, AL, 366953408, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-344-8588 |
| Fax | 2513448985 |
Authorized person
| Name | DR. JOHN MATTHEW YOUNGBLOOD |
| Role | PRESIDENT |
| Phone | 2513448588 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 1101 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED HEALTH CARE |
| Number | 4410063 |
| State | AL |
| Issuer | PRINCIPAL HEALTH |
| Number | 14767 |
| State | AL |
| Issuer | AETNA |
| Number | 4664879 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51070922 |
| State | AL |
| Issuer | VIVA |
| Number | T68625 |
| State | AL |
| Issuer | FIRST HEALTH |
| Number | 770616 |
| State | AL |
| Issuer | CCN |
| Number | 388534 |
| State | AL |
| Name | Role |
|---|---|
| YOUNGBLOOD, J MATTHEW | Agent |
| Name | Role |
|---|---|
| YOUNGBLOOD, J MATTHEW | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2004-01-08 | Name Change | Youngblood Chiropractic, P.C. | West Mobile Chiropractic, P.C. |
| 1995-02-22 | Name Change | West Mobile Chiropractic, P.C. | Youngblood Chiropractic, P.C. |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
