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Total Rehab Chiropractic, LLC

Details

Name: Total Rehab Chiropractic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 22 Oct 2002 (22 years ago) (Companies founded in October 2002)
Entity Number: 000-685-483
Register Number: 000685483
ZIP code: 36830 (Companies in Lee, 36830)
County: Lee
Place of Formation: Lee County
Principal Address: AUBURN, AL
Registered Office Street Address: 2515 E GLENN AVE STE 104AUBURN, AL 36830

Activities CHIROPRACTIC CARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770774846 2007-08-05 2007-08-05 2515 E GLENN AVE, SUITE 104, AUBURN, AL, 368306453, US 2515 E GLENN AVE, SUITE 104, AUBURN, AL, 368306453, US

Contacts

Phone +1 334-821-2256
Fax 3348268082

Authorized person

Name JOHN H MANN III
Role CHIROPRACTOR
Phone 3348212256

Taxonomy

Taxonomy Code 111N00000X - Chiropractor
License Number 1107
State AL
Is Primary Yes

Other Provider Identifiers

Issuer BLUECROSS BLUESHIELD
Number 51516578
State AL

Agent

Name Role
MANN, JOHN H Agent

Member

Name Role Address
MANN, JOHN H III Member 2515 EAST GLENN AVENUE SUITE 104AUBURN, AL 36830

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State