| Name: | Coosa Valley Sports Medicine and Primary Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 06 Dec 2013 (11 years ago) (Companies founded in December 2013) |
| Date of dissolution: | 09 Jul 2018 |
| Entity Number: | 000-292-737 |
| Register Number: | 000292737 |
| ZIP code: | 35150 (Companies in Talladega, 35150) |
| County: | Talladega |
| Place of Formation: | Talladega County |
| Registered Office Street Address: | 209 WEST SPRING STREET SUITE 305SYLACAUGA, AL 35150 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871924357 | 2013-12-09 | 2013-12-09 | 209 W SPRING ST, SUITE 305, SYLACAUGA, AL, 351502973, US | 209 W SPRING ST, SUITE 305, SYLACAUGA, AL, 351502973, US | |||||||||||||||||||
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| Phone | +1 256-245-3201 |
| Fax | 2562454112 |
Authorized person
| Name | KENNIETH C MCCOLLOUGH |
| Role | OWNER |
| Phone | 2562453201 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD.29754 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MCCOLLOUGH, KENNIETH | Agent |
| Name | Role | Address |
|---|---|---|
| WINGER, ADAM S | Organizer | 420 NORTH 20TH STREET SUITE 1400BIRMINGHAM, AL 35203 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
