| Name: | Innate Chiropractic, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 02 Nov 2006 (18 years ago) |
| Date of dissolution: | 24 Feb 2017 |
| Entity Number: | 000-249-771 |
| Register Number: | 000249771 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 3956 BRIAR OAK DRBIRMINGHAM, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| Authorized Capital: | $1,000 |
Activities
CHIROPRACTIC CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831305937 | 2007-05-15 | 2020-08-22 | 305 HEATH DR, BIRMINGHAM, AL, 352424028, US | 3017 PUMP HOUSE RD, BIRMINGHAM, AL, 352431847, US | |||||||||||||||||||||||||
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| Phone | +1 205-380-0574 |
| Fax | 2059685854 |
Authorized person
| Name | DR. LAKE FRANKLIN |
| Role | PRESIDENT |
| Phone | 2053942340 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2181 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51539961 |
| State | AL |
| Name | Role |
|---|---|
| POLHEMUS, WILLIAM L | Agent |
| Name | Role |
|---|---|
| FRANKLIN, LAKE POLHEMUS | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
