| Name: | Bennett Chiropractic, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 15 Feb 2002 (23 years ago) |
| Entity Number: | 000-221-361 |
| Register Number: | 000221361 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | MADISON, AL |
| Registered Office Street Address: | 8694 MADISON BLVD STE DMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| Authorized Capital: | $100 |
Activities
CHIROPRACTIC CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710162854 | 2008-01-08 | 2008-04-18 | 120 W DUBLIN DR, 102, MADISON, AL, 357583155, US | 120 W DUBLIN DR, 102, MADISON, AL, 357583155, US | |||||||||||||||||||||||
|
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| Phone | +1 256-774-7189 |
Authorized person
| Name | DR. WALTER CHARLES BENNETT |
| Role | PRESIDENT |
| Phone | 2567747189 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2025 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHEILD |
| Number | 51507154 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BENNETT, WALTER | Agent | 196 EMERSON ROADMADISON, AL 35758 |
| Name | Role | Address |
|---|---|---|
| BENNETT, WALTER | Incorporator | 196 EMERSON ROADMADISON, AL 35758 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
