| Name: | Fyzical of Montgomery, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 26 Sep 2019 (5 years ago) |
| Date of dissolution: | 12 Oct 2022 |
| Entity Number: | 000-588-595 |
| Register Number: | 000588595 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 1300 MCFARLAND BLVD NE STE 150TUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639712656 | 2019-10-22 | 2021-03-30 | 5923 MONTICELLO DR, MONTGOMERY, AL, 361171940, US | 129 MITYLENE PARK LN, MONTGOMERY, AL, 361177302, US | |||||||||||||||
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| Phone | +1 334-593-4462 |
| Fax | 3345934135 |
Authorized person
| Name | DUSTIN CLARY |
| Role | OWNER/PHYSICAL THERAPIST |
| Phone | 3345934462 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FYZICAL OF MONTEGOMERY LLC 401(K) PLAN | 2021 | 843183923 | 2022-12-29 | FYZICAL OF MONTGOMERY LLC | 8 | |||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2022-12-29 |
| Name of individual signing | DEDE CLARY |
| Role | Employer/plan sponsor |
| Date | 2022-12-29 |
| Name of individual signing | DEDE CLARY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 2056570184 |
| Plan sponsor’s address | 5923 MONTICELLO DRIVE, MONTGOMERY, AL, 36117 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | TAG RESOURCES LLC |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2022-08-12 |
| Name of individual signing | TARA EVANS |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 2056570184 |
| Plan sponsor’s address | 129 MITYLENE PK LN, MONTGOMERY, AL, 36117 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | TAG RESOURCES LLC |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-20 |
| Name of individual signing | DEDE CLARY |
| Name | Role |
|---|---|
| CLARY, DUSTIN | Agent |
| Name | Role | Address |
|---|---|---|
| STAGGS, CLAY | Organizer | 701 22ND AVENUE, SUITE 1TUSCALOOSA, AL 35401 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
