| Name: | Promise Physical Therapy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 28 May 2002 (22 years ago) |
| Entity Number: | 000-223-200 |
| Register Number: | 000223200 |
| County: | Autauga |
| Place of Formation: | Autauga County |
| Principal Address: | PRATTVILLE, AL |
| Registered Office Street Address: | 459 EAST MAIN STPRATTVILLE, AL 36067 |
| Registered Office Street Address ZIP Code: | 36067 |
| Authorized Capital: | $100 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598790065 | 2006-07-12 | 2013-06-07 | 640 MCQUEEN SMITH RD N, PRATTVILLE, AL, 360667511, US | 640 MCQUEEN SMITH RD N, PRATTVILLE, AL, 360667511, US | |||||||||||||||||||||||||
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| Phone | +1 334-358-2201 |
| Fax | 3343582236 |
Authorized person
| Name | MR. EDWIN PRICE GRICE III |
| Role | PRESIDENT |
| Phone | 3343582201 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT1534 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51515426 |
| State | AL |
| Name | Role |
|---|---|
| GRICE, EDWIN P III | Agent |
| Name | Role |
|---|---|
| GRICE, EDWIN P III | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
