| Name: | Integrity Therapy Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 16 Jun 2004 (20 years ago) (Companies founded in June 2004) |
| Entity Number: | 000-452-478 |
| Register Number: | 000452478 |
| ZIP code: | 35630 (Companies in Lauderdale, 35630) |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Street Address: | 416 N SEMINARY STFLORENCE, AL 35630 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962554477 | 2007-01-17 | 2023-06-07 | 302 W DR HICKS BLVD, FLORENCE, AL, 356306160, US | 302 W DR HICKS BLVD, FLORENCE, AL, 356306160, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-764-1442 |
| Fax | 2567641366 |
Authorized person
| Name | GREG MILES |
| Role | OWNER |
| Phone | 2567641442 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | PTH775 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529920700 |
| State | AL |
| Issuer | BLUE CROSS ID |
| Number | 51523294 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MILES, GREGORY | Agent | 790 WASHINGTON FERRY RDPRATTVILLE, AL 36067 |
| Name | Role |
|---|---|
| MILES, DONNA ALSBROOKS | Member |
| MILES, GREGORY TIMOTHY | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
