| Name: | Cleansing Waters Wellness Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Aug 2015 (9 years ago) |
| Entity Number: | 000-343-320 |
| Register Number: | 000343320 |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Registered Office Street Address: | 1300 JOHN R ST SUITE BMUSCLE SHOALS, AL 35661 |
| Registered Office Street Address ZIP Code: | 35661 |
| Registered Office Mailing Address: | 111 CHESTNUT LNSHEFFIELD, AL 35660 |
| Registered Office Mailing Address ZIP Code: | 35660 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417326463 | 2015-09-21 | 2015-09-21 | 1300 JOHN R ST, SUITE B, MUSCLE SHOALS, AL, 356612255, US | 1300 JOHN R ST, SUITE B, MUSCLE SHOALS, AL, 356612255, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 256-314-2328 |
| Fax | 2563142328 |
Authorized person
| Name | NATHAN A REYNOLDS |
| Role | OWNER/MASSAGE THERAPIST |
| Phone | 2563142328 |
Taxonomy
| Taxonomy Code | 225500000X - Respiratory/Developmental/Rehabilitative Specialist/Technologist |
| State | TX |
| Is Primary | No |
| Taxonomy Code | 225700000X - Massage Therapist |
| License Number | 4315 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | 4315 |
| State | AL |
| Name | Role |
|---|---|
| REYNOLDS, NATHAN A | Agent |
| Name | Role |
|---|---|
| REYNOLDS, NATHAN A | Organizer |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
