| Name: | Randolph Chiropractic Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Nov 2005 (19 years ago) |
| Entity Number: | 000-471-680 |
| Register Number: | 000471680 |
| County: | Saint Clair |
| Place of Formation: | Saint Clair County |
| Principal Address: | PELL CITY, AL |
| Registered Office Street Address: | 130 FERN CIRCLEPELL CITY, AL 35125 |
| Registered Office Street Address ZIP Code: | 35125 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174627418 | 2006-09-08 | 2007-10-11 | PO BOX 370, GUIN, AL, 35563, US | 7596 US HWY 43, GUIN, AL, 35563, US | |||||||||||||||||||||||
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| Phone | +1 205-468-3464 |
| Fax | 2054683724 |
Authorized person
| Name | MR. KENNETH J RANDOLPH |
| Role | OWNER OF BUSINESS |
| Phone | 2054683464 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 1931 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51003438 |
| Name | Role |
|---|---|
| EMERSON, STEVE | Agent |
| Name | Role |
|---|---|
| RANDOLPH, KENNETH J | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
