| Name: | Preventive Care Medical Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 12 May 2009 (15 years ago) |
| Entity Number: | 000-433-842 |
| Register Number: | 000433842 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | IRONDALE, AL |
| Registered Office Street Address: | 5279 OVERTON RDIRONDALE, AL 35210 |
| Registered Office Street Address ZIP Code: | 35210 |
Activities
PATIENT CARE/RESEARCH
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871847988 | 2012-10-29 | 2012-10-29 | 210 NORTH ST W, SUITE C, TALLADEGA, AL, 351602083, US | 210 NORTH ST W, SUITE C, TALLADEGA, AL, 351602083, US | |||||||||||||
|
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| Phone | +1 256-362-0066 |
Authorized person
| Name | DR. ANTHONY LESSA |
| Role | PHYSICIAN |
| Phone | 2563620066 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| LESSA, ANTHONY | Member |
| LESSA, GRACE | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
