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Trussville Foot Care Center, P.C.

Details

Name: Trussville Foot Care Center, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 15 Dec 1998 (26 years ago)
Date of dissolution: 13 Jun 2014
Entity Number: 000-199-545
Register Number: 000199545
County: Jefferson
Place of Formation: Jefferson County
Principal Address: TRUSSVILLE, AL
Registered Office Street Address: 1930 EDWARDS LAKE RDBIRMINGHAM, AL 35235
Registered Office Street Address ZIP Code: 35235
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE OF PODIATRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043456254 2008-12-18 2008-12-18 1930 EDWARDS LAKE RD, SUITE 138, BIRMINGHAM, AL, 352353718, US 1930 EDWARDS LAKE RD, SUITE 138, BIRMINGHAM, AL, 352353718, US

Contacts

Phone +1 205-661-1400

Authorized person

Name DAVID ANDERSON
Role OWNER
Phone 2056611400

Taxonomy

Taxonomy Code 213E00000X - Podiatrist
License Number 209
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529906320
State AL

Agent

Name Role
ANDERSON, DAVID Q Agent

Incorporator

Name Role
ANDERSON, DAVID QUENTIN Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State