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MD Wellness Clinic, LLC

Details

Name: MD Wellness Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Dec 2020 (4 years ago)
Entity Number: 000-825-133
Register Number: 000825133
County: Cullman
Place of Formation: Etowah County
Registered Office Street Address: 2021 AL-157 SUITE ACULLMAN, AL 35058
Registered Office Street Address ZIP Code: 35058

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972334332 2024-08-08 2024-08-08 2021 AL HIGHWAY 157 STE A, CULLMAN, AL, 350580687, US 2021 AL HIGHWAY 157 STE A, CULLMAN, AL, 350580687, US

Contacts

Phone +1 256-841-1704
Fax 2568411563

Authorized person

Name MRS. ASHLEY CAMPBELL DRAKE
Role CO-OWNER/MANAGER
Phone 2568411704

Taxonomy

Taxonomy Code 261QR0800X - Recovery Care Clinic/Center
Is Primary Yes

Agent

Name Role Address
MOHIUDDIN, HASAN Agent 1924 STRAWBERRY LANEHOOVERN, AL 35244

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State