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Wiregrass Podiatry LLC

Details

Name: Wiregrass Podiatry LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 30 Jul 2018 (6 years ago) (Companies founded in July 2018)
Entity Number: 000-525-395
Register Number: 000525395
ZIP code: 36330 (Companies in Coffee, 36330)
County: Coffee
Place of Formation: Coffee County
Registered Office Street Address: 107 E WATTS STENTERPRISE, AL 36330
Registered Office Mailing Address: 115 FALKIRK DRDOTHAN, AL 36305

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952873283 2018-12-27 2020-09-28 1008 BOLL WEEVIL CIR STE B, ENTERPRISE, AL, 363303400, US 1008 BOLL WEEVIL CIR STE B, ENTERPRISE, AL, 363303400, US

Contacts

Phone +1 334-494-8200
Fax 3344601984

Authorized person

Name JENNIFER ROSE DECKER
Role ADMINISTRATOR
Phone 3344948200

Taxonomy

Taxonomy Code 213E00000X - Podiatrist
Is Primary Yes

Agent

Name Role Address
DECKER, JENNIFER R DPM Agent 107 E WATTS STENTERPRISE, AL 36330

Organizer

Name Role Address
DECKER, JENNIFER R DPM Organizer 107 E WATTS STENTERPRISE, AL 36330

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State