| Name: | GRAVELY CHIROPRACTIC, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 28 Dec 2005 (19 years ago) (Companies founded in December 2005) |
| Date of dissolution: | 13 Oct 2015 |
| Entity Number: | 000-245-051 |
| Register Number: | 000245051 |
| ZIP code: | 36561 (Companies in Baldwin, 36561) |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | ORANGE BEACH, AL |
| Registered Office Street Address: | 27250 STE A PERDIDO BEACH BLVDORANGE BEACH, AL 36561 |
| Authorized Capital: | $1,000 |
Activities
CHIROPRACTIC MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356556815 | 2007-05-10 | 2014-11-20 | PO BOX 2157, ORANGE BEACH, AL, 365612157, US | 4223 ORANGE BEACH BLVD, SUITE B, ORANGE BEACH, AL, 365613459, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 251-980-2225 |
| Fax | 2519802779 |
| Fax | 2519802778 |
Authorized person
| Name | DR. STEVEN W GRAVELY |
| Role | CHIROPRACTOR |
| Phone | 2519802225 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2132 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF AL |
| Number | 32474 |
| State | AL |
| Issuer | MEDICARE PTAN |
| Number | K750 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| GRAVELY, STEVEN W | Agent | 2659 HAMPTON PARK CIRCLEFOLEY, AL 36535 |
| Name | Role | Address |
|---|---|---|
| GRAVELY, STEVEN W | Incorporator | 2659 HAMPTON PARK CIRCLEFOLEY, AL 36535 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
