| Name: | Cullman Spine Institute, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 07 Jul 2006 (18 years ago) |
| Entity Number: | 000-248-302 |
| Register Number: | 000248302 |
| County: | Cullman |
| Place of Formation: | Cullman County |
| Principal Address: | CULLMAN, AL |
| Registered Office Street Address: | 1890 AL HWY 157 STE 430CULLMAN, AL 35058 |
| Registered Office Street Address ZIP Code: | 35058 |
| Authorized Capital: | 1,000 |
Activities
MEDICAL PRACTICE OF SPINE TREATMENT/SPINE SURGERY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548377302 | 2006-08-25 | 2016-04-15 | 1300 BRIDGE CREEK DR NE, SUITE B, CULLMAN, AL, 350551300, US | 1300 BRIDGE CREEK DR NE, SUITE B, CULLMAN, AL, 350551300, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 256-734-7707 |
| Fax | 2567347796 |
Authorized person
| Name | JULIE JENNINGS |
| Role | OFFICE MANAGER |
| Phone | 2567347707 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PATRICK SWINEA - PHYSICAL |
| Number | 1366514945 |
| Issuer | JENNIFER KNOWLTON - PHYSI |
| Number | 158863807 |
| Issuer | MEDICAID |
| Number | 009939046 |
| State | AL |
| Name | Role |
|---|---|
| WARD, ROBERT A | Agent |
| Name | Role |
|---|---|
| WARD, ROBERT A | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
