| Name: | Coastal Chiropractic L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Aug 2013 (11 years ago) |
| Entity Number: | 000-284-126 |
| Register Number: | 000284126 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 29000 US HIGHWAY 98 BLDG B STE 101DAPHNE, AL 36526 |
| Principal Address ZIP Code: | 36526 |
Activities
CHIROPRACTIC AND SPORTS REHABILITATION CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467889261 | 2013-10-11 | 2023-09-19 | 27535 US HIGHWAY 98, DAPHNE, AL, 365264839, US | 27535 US HIGHWAY 98, DAPHNE, AL, 365264839, US | |||||||||||||||||||||||||
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| Phone | +1 251-375-0131 |
| Fax | 2513750132 |
Authorized person
| Name | DR. RYAN PATRICK NOBLES |
| Role | OWNER |
| Phone | 2513750131 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2412 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51141426 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| NOBLES, RYAN P | Agent | 132-D DU RHU DRMOBILE, AL 36608 |
| Name | Role | Address |
|---|---|---|
| LITTLE, ELIZABETH S | Organizer | 132-D DU RHU DRMOBILE, AL 36608 |
| NOBLES, RYAN P | Organizer | 132-D DU RHU DRMOBILE, AL 36608 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
