| Name: | Park South Physical Therapy, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 17 Jul 1989 (35 years ago) |
| Entity Number: | 000-132-071 |
| Register Number: | 000132071 |
| County: | Tallapoosa |
| Place of Formation: | Tallapoosa County |
| Principal Address: | ALEXANDER CITY, AL |
| Registered Office Street Address: | ROUTE 1 BOX 210-AALEXANDER CITY, AL 35010 |
| Registered Office Street Address ZIP Code: | 35010 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366598179 | 2007-01-25 | 2013-04-09 | 33310 US HIGHWAY 280, CHILDERSBURG, AL, 350443121, US | 33310 US HIGHWAY 280, CHILDERSBURG, AL, 350443121, US | |||||||||||||||||||||||||
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| Phone | +1 256-378-3390 |
| Fax | 2563783391 |
Authorized person
| Name | EDWARD DUNCAN CROWDER |
| Role | PRESIDENT |
| Phone | 2563783390 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | 288 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PT LICENSE |
| Number | PTH288 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CROWDER, EDWARD DUNCAN | Agent | 1414 SPRING VALLEY LANESYLACAUGA, AL 35150 |
| Name | Role | Address |
|---|---|---|
| CROWDER, EDWARD DUNCAN | Incorporator | 1414 SPRING VALLEY LANESYLACAUGA, AL 35150 |
| CROWDER, MARGARET BROWN | Incorporator | No data |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
