| Name: | Eastern Shore Chiropractic & Sports Clinic, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 18 Sep 2009 (15 years ago) |
| Entity Number: | 000-262-071 |
| Register Number: | 000262071 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | DAPHNE, AL |
| Registered Office Street Address: | 739 BIG CANOE RUNFAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
| Authorized Capital: | $10 |
Activities
PROVIDE CHIROPRACTIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679809644 | 2009-10-27 | 2009-10-27 | 151 FLY CREEK AVENUE, SUITE 411, FAIRHOPE, AL, 365323843, US | 151 FLY CREEK AVENUE, SUITE 411, FAIRHOPE, AL, 365323843, US | |||||||||||||||||
|
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| Phone | +1 225-274-5507 |
Authorized person
| Name | DR. JUSTIN FISHER SOUTHALL |
| Role | PRESIDENT/OWNER |
| Phone | 2252745507 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2292 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SOUTHALL, JUSTIN FISHER | Agent |
| Name | Role | Address |
|---|---|---|
| RYAN, DAVID A | Incorporator | 112 WEST LAUREL AVEFOLEY, AL 36535 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
