| Name: | Port City Family Chiropractic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 05 Feb 2015 (10 years ago) |
| Entity Number: | 000-328-558 |
| Register Number: | 000328558 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 6345 D COTTAGE HILL ROADMOBILE, AL 36609 |
| Registered Office Street Address ZIP Code: | 36609 |
Activities
NOT PROVIDED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598152118 | 2015-04-21 | 2015-04-21 | 6345 COTTAGE HILL RD, SUITE D, MOBILE, AL, 36695, US | 6345 COTTAGE HILL RD, SUITE D, MOBILE, AL, 36695, US | |||||||||||||||||||||||
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| Phone | +1 239-297-5106 |
Authorized person
| Name | DR. SAMANTHA CHIRICHELLA |
| Role | CHIROPRACTOR |
| Phone | 2392975106 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2434 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI-INDIVIDUAL |
| Number | 1548655632 |
| State | AL |
| Name | Role |
|---|---|
| CHIRICHELLA, SAMANTHA | Agent |
| Name | Role | Address |
|---|---|---|
| BROWN, CARRI | Organizer | 26025 MUREAU RD. SUITE 120CALABASAS, CA 91302 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
