| Name: | Dr. Celeste Reese Willis Medical Group LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Jun 2020 (4 years ago) |
| Entity Number: | 000-635-784 |
| Register Number: | 000635784 |
| ZIP code: | 35802 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 600 BLVD SOUTH SW STE 104JHUNTSVILLE, AL 35802 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083228597 | 2020-09-02 | 2023-03-02 | 944 NARROWS POINT DR, BIRMINGHAM, AL, 352428672, US | 401 TUSCALOOSA AVE SW STE 210, BIRMINGHAM, AL, 352111486, US | |||||||||||||||||||||
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| Phone | +1 205-747-9340 |
| Fax | 2052359592 |
| Phone | +1 205-291-8842 |
Authorized person
| Name | DR. CELESTE REESE WILLIS |
| Role | CEO |
| Phone | 2052918842 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| USCA INC | Agent | 101 N BRAND BLVD 11TH FLGLENDALE, CA 91203 |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM INC | Organizer | 101 N BRAND BLVD 10TH FLOORGLENDALE, CA 91203 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
