Montgomery Spine Center, P.C.

Details

Name:	Montgomery Spine Center, P.C.
Jurisdiction:	Alabama
Legal type:	Domestic Professional Corporation
Status:	Exists
Date of registration:	09 Nov 1999 (25 years ago)
Entity Number:	000-206-389
Register Number:	000206389
County:	Montgomery
Place of Formation:	Montgomery County
Principal Address:	MONTGOMERY, AL
Registered Office Street Address:	257 WINTON M BLOUNT LOOPMONTTGOMERY, AL 36117
Registered Office Street Address ZIP Code:	36117
Authorized Capital:	$2,000

Activities MEDICAL PRACTICE SPECIALIZING IN ORTHOPEDICS

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1568521169

2006-12-08

2011-08-02

257 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117, US

257 WINTON BLOUNT LOOP, MONTGOMERY, AL, 36117, US

Contacts

Phone	+1 334-396-1886
Fax	3343960608

Authorized person

Name	TIMOTHY A HOLT
Role	PRESIDENT
Phone	3343961886

Taxonomy

Taxonomy Code	111NX0800X - Orthopedic Chiropractor
Is Primary	Yes

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2023

631237270

2024-09-05

MONTGOMERY SPINE CENTER, P.C.

14

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2022

631237270

2023-09-18

MONTGOMERY SPINE CENTER, P.C.

9

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2021

631237270

2022-10-05

MONTGOMERY SPINE CENTER, P.C.

8

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2020

631237270

2021-07-13

MONTGOMERY SPINE CENTER, P.C.

12

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2019

631237270

2020-09-25

MONTGOMERY SPINE CENTER, P.C.

12

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2018

631237270

2019-09-30

MONTGOMERY SPINE CENTER, P.C.

12

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2017

631237270

2018-09-28

MONTGOMERY SPINE CENTER, P.C.

13

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2016

631237270

2017-08-25

MONTGOMERY SPINE CENTER, P.C.

11

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2015

631237270

2016-09-29

MONTGOMERY SPINE CENTER, P.C.

13

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

MONTGOMERY SPINE CENTER, P.C. 401(K) PROFIT SHARING PLAN

2014

631237270

2015-09-08

MONTGOMERY SPINE CENTER, P.C.

10

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	3343961886
Plan sponsor’s address	257 WINTON M. BLOUNT LOOP, MONTGOMERY, AL, 36117

Signature of

Role	Plan administrator
Date	2015-09-08
Name of individual signing	TERRY PHILLIPS

Role	Employer/plan sponsor
Date	2015-09-08
Name of individual signing	TERRY PHILLIPS

Agent

Name	Role
HOLT, TIMOTHY A	Agent

Incorporator

Name	Role
HOLT, TIMOTHY A	Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State