| Name: | REHAB & WELLNESS CLINIC, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Apr 2015 (10 years ago) |
| Entity Number: | 000-334-074 |
| Register Number: | 000334074 |
| County: | Walker |
| Place of Formation: | Cullman County |
| Registered Office Street Address: | 1090 HWY 78 EASTJASPER, AL 35501 |
| Registered Office Street Address ZIP Code: | 35501 |
Activities
NOT PROVIDED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043870231 | 2019-06-19 | 2019-06-19 | 1090 HIGHWAY 78 E, JASPER, AL, 35501, US | 234 NORTH BROADWAY, SYLACAUGA, AL, 35150, US | |||||||||||||||||||
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| Phone | +1 205-387-9787 |
| Fax | 2055442909 |
| Phone | +1 256-249-5500 |
| Fax | 2562495506 |
Authorized person
| Name | SAMIA MOIZUDDIN |
| Role | PHYSICIAN |
| Phone | 2053879787 |
Taxonomy
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MOIZUDDIN, SAMIA | Agent |
| Name | Role |
|---|---|
| WILLINGHAM, DAN | Organizer |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
