| Name: | Hueytown Chiropractic Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Jul 1998 (26 years ago) (Companies founded in July 1998) |
| Entity Number: | 000-660-565 |
| Register Number: | 000660565 |
| ZIP code: | 35023 (Companies in Jefferson, 35023) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | HUEYTOWN, AL |
| Registered Office Street Address: | 3166 ALLISON BONNETT MEM DRHUEYTOWN, AL 35023 |
Activities
CHIROPRACTIC CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982870630 | 2008-05-02 | 2010-03-17 | 3166 ALLISON BONNETT MEMORIAL DR, HUEYTOWN, AL, 350231641, US | 3166 ALLISON BONNETT MEMORIAL DR, HUEYTOWN, AL, 350231641, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 205-491-6881 |
| Fax | 2054916881 |
Authorized person
| Name | DR. PETER JAMES DEFRANCO II |
| Role | MANAGING MEMBER |
| Phone | 2054916881 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 1105 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UPIN |
| Number | T68393 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 44788 |
| State | AL |
| Issuer | MEDICARE |
| Number | K313 |
| State | AL |
| Name | Role |
|---|---|
| DEFRANCO, PETER J | Agent |
| Name | Role |
|---|---|
| DEFRANCO, PETER J | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
