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Cullman Spine Institute, Inc.

Details

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

National Provider Identifier

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

Contacts

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

Agent

Name Role
WARD, ROBERT A Agent

Incorporator

Name Role
WARD, ROBERT A Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State