| Name: | Pediatric Therapy Link of North Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 09 Jun 2004 (20 years ago) |
| Entity Number: | 000-452-323 |
| Register Number: | 000452323 |
| County: | Madison |
| Place of Formation: | Montgomery County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 3313 MEMORIAL PKY SW STE 122HUNTSVILLE, AL 35801 |
| Registered Office Street Address ZIP Code: | 35801 |
Activities
OCCUPATIONAL THERAPY PEDIATRIC PRIVATE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447448550 | 2007-10-15 | 2010-12-09 | 97 HUGHES RD STE H, MADISON, AL, 357583401, US | 97 HUGHES RD STE H, MADISON, AL, 357583401, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 256-883-7338 |
| Fax | 2568837135 |
Authorized person
| Name | MS. MARY THERESE MAYHAN |
| Role | OWNER/OCCUPATIONAL THERAPIST |
| Phone | 2568837338 |
Taxonomy
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| License Number | 2306 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBSAL |
| Number | 51523367 |
| State | AL |
| Name | Role |
|---|---|
| MAYHAN, MARY | Agent |
| Name | Role |
|---|---|
| MAYHAN, MARY | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
