| Name: | Wiregrass Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 31 Mar 2010 (15 years ago) (Companies founded in March 2010) |
| Entity Number: | 000-619-379 |
| Register Number: | 000619379 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 4000 MERIDIAN BLVDFRANKLIN, TN 37067 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851063432 | 2021-10-01 | 2021-10-01 | PO BOX 689022, FRANKLIN, TN, 370689022, US | 4300 W MAIN ST STE 405, DOTHAN, AL, 363051086, US | |||||||||||||||||||
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| Phone | +1 615-465-7230 |
| Fax | 6156286877 |
| Phone | +1 334-944-7073 |
| Fax | 3349447058 |
Authorized person
| Name | JENNIFER L JACKSON |
| Role | SR DIR PROV ENROLLMENT & ONBOARDING |
| Phone | 6154653334 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
