| Name: | Total Rehab Physical Therapy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 22 Oct 2002 (22 years ago) |
| Date of dissolution: | 13 Apr 2022 |
| Entity Number: | 000-685-484 |
| Register Number: | 000685484 |
| County: | Lee |
| Place of Formation: | Lee County |
| Principal Address: | AUBURN, AL |
| Registered Office Street Address: | 2515 E GLENN AVE STE 104AUBURN, AL 36830 |
| Registered Office Street Address ZIP Code: | 36830 |
Activities
PHYSICAL THERAPY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407047574 | 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 | |||||||||||||||||||||||||||||||
|
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| Phone | +1 334-821-2256 |
| Fax | 3348268082 |
Authorized person
| Name | THOMAS EVANS |
| Role | PHYSICAL THERAPIST |
| Phone | 3348212256 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PTH2853 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECROSS BLUESHIELD |
| Number | 51512447 |
| State | AL |
| Issuer | PALMETTOGB-RAILROAD |
| Number | P00039795 |
| State | AL |
| Name | Role |
|---|---|
| EVANS, THOMAS D | Agent |
| Name | Role |
|---|---|
| EVANS, THOMAS D | Member |
| GARNER, TYLER M | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
