| Name: | Robert Funk & Associates Physical Therapy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 06 Feb 2006 (19 years ago) |
| Entity Number: | 000-245-639 |
| Register Number: | 000245639 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 3500 BLUE LAKE DR STE 495BIRMINGHAM, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| Authorized Capital: | $100 |
Activities
PHYSICAL THERAPY SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891837712 | 2007-02-14 | 2012-08-09 | 2345 MOODY PKWY, STE 206, MOODY, AL, 350043004, US | 2345 MOODY PKWY, STE 206, MOODY, AL, 350043004, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-640-4881 |
| Fax | 2056404882 |
Authorized person
| Name | DEAN SPEERS |
| Role | VP, DIRECTOR OF BUSINESS OPERATIONS |
| Phone | 2056404881 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PTH3350 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS OF AL |
| Number | 51533197 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MOSES, CHARLES H III | Agent | 4000 EAGLE POINT CORPORATE DRBIRMINGHAM, AL 35242-7358 |
| Name | Role |
|---|---|
| SPEERS, RICHARD D | Incorporator |
| FUNK, ROBERT | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
