| Name: | Spine & Sport Chiropractic, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 22 Jan 2004 (21 years ago) |
| Entity Number: | 000-233-195 |
| Register Number: | 000233195 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | NORTHPORT, AL |
| Registered Office Street Address: | 12289 LESTER TAYLOR RDNORTHPORT, AL 35475 |
| Registered Office Street Address ZIP Code: | 35475 |
| Authorized Capital: | 10,000 |
Activities
CHIROPRACTICE HEALTH CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942353743 | 2007-01-18 | 2013-04-09 | 1800 MCFARLAND BLVD E STE 340, TUSCALOOSA, AL, 354045882, US | 1800 MCFARLAND BLVD E STE 340, TUSCALOOSA, AL, 354045882, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 205-393-4308 |
Authorized person
| Name | DR. BRYAN H MCDONALD |
| Role | PRESIDENT |
| Phone | 2053934308 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2082 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51527164 |
| State | AL |
| Issuer | INDIVIDUAL NPI |
| Number | 1104860766 |
| State | AL |
| Name | Role |
|---|---|
| MCDONALD, BRYAN H | Agent |
| Name | Role |
|---|---|
| MCDONALD, BRYAN H | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
