| Name: | Three Notch Chiropractic LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Apr 2008 (17 years ago) |
| Entity Number: | 000-418-912 |
| Register Number: | 000418912 |
| County: | Covington |
| Place of Formation: | Covington County |
| Principal Address: | ANDALUSIA, AL |
| Registered Office Street Address: | 504 E THREE NOTCH STANDALUSIA, AL 36420 |
| Registered Office Street Address ZIP Code: | 36420 |
Activities
CHIROPRACTIC CARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356597454 | 2008-08-08 | 2008-08-08 | PO BOX 1093, ANDALUSIA, AL, 364201222, US | 504 E THREE NOTCH ST, ANDALUSIA, AL, 364203128, US | |||||||||||||||||||||||||
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| Phone | +1 334-352-4019 |
| Fax | 3343524019 |
Authorized person
| Name | DR. CHARLES JONATHAN RALEY IV |
| Role | OWNER |
| Phone | 3343524019 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 2242 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF ALABAMA |
| Number | 51548679 |
| State | AL |
| Name | Role |
|---|---|
| RALEY, CHARLES J IV | Agent |
| Name | Role |
|---|---|
| RALEY, CHARLES J IV | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
