| Name: | Phillip B. Tickner, OD & Associates, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 Feb 2008 (17 years ago) |
| Entity Number: | 000-415-742 |
| Register Number: | 000415742 |
| County: | Jefferson |
| Place of Formation: | Saint Clair County |
| Principal Address: | TRUSSVILLE, AL |
| Registered Office Street Address: | 109 ANDERSON CIRCLETRUSSVILLE, AL 35173 |
| Registered Office Street Address ZIP Code: | 35173 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578890885 | 2009-11-06 | 2010-05-18 | 109 ANDERSON CIR, TRUSSVILLE, AL, 351731001, US | 8551 WHITFIELD AVE, LEEDS, AL, 350947560, US | |||||||||||||||||||||||
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| Phone | +1 205-919-0671 |
| Fax | 2057392027 |
| Phone | +1 205-699-0719 |
| Fax | 2056990722 |
Authorized person
| Name | PHILLIP BRYAN TICKNER |
| Role | OD |
| Phone | 2059190671 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | SB65TA769 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| TICKNER, PHILLIP B | Agent |
| Name | Role |
|---|---|
| TICKNER, PHILLIP B | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
