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Robert Funk & Associates Physical Therapy, Inc.

Details

Name: Robert Funk & Associates Physical Therapy, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 06 Feb 2006 (19 years ago) (Companies founded in February 2006)
Entity Number: 000-245-639
Register Number: 000245639
ZIP code: 35243 (Companies in Jefferson, 35243)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 3500 BLUE LAKE DR STE 495BIRMINGHAM, AL 35243
Authorized Capital: $100

Activities PHYSICAL THERAPY SERVICES

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
MOSES, CHARLES H III Agent 4000 EAGLE POINT CORPORATE DRBIRMINGHAM, AL 35242-7358

Incorporator

Name Role
SPEERS, RICHARD D Incorporator
FUNK, ROBERT Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State