| Name: | Bold Life Chiropractic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Mar 2013 (12 years ago) |
| Entity Number: | 000-276-076 |
| Register Number: | 000276076 |
| County: | Autauga |
| Place of Formation: | Autauga County |
| Principal Address: | 696-A COMMERCE COURTPRATTVILLE, AL 36066 |
| Principal Address ZIP Code: | 36066 |
| Registered Office Street Address: | 427 EAST MAIN STREETPRATTVILLE, AL 36067 |
| Registered Office Street Address ZIP Code: | 36067 |
Activities
CHIROPRACTIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518390293 | 2013-08-16 | 2019-02-26 | 427 E MAIN ST, PRATTVILLE, AL, 360673409, US | 427 E MAIN ST, PRATTVILLE, AL, 360673409, US | |||||||||||||||||||
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| Phone | +1 334-356-5571 |
| Fax | 3347300971 |
Authorized person
| Name | DR. JOSHUA P WHITE |
| Role | PRESIDENT |
| Phone | 3343565571 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | 1145 |
| Name | Role | Address |
|---|---|---|
| WHITE, JOSHUA P | Agent | 1816 HIGH VALLEY ROADPRATTVILLE, AL 36067 |
| Name | Role | Address |
|---|---|---|
| KEMP, AMANDA | Organizer | 1032 BAYFIELD DRIVE SEHUNTSVILLE, AL 35802 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
