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ELITE REHAB WEDOWEE LLC

Details

Name: ELITE REHAB WEDOWEE LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 16 Jun 2021 (3 years ago) (Companies founded in June 2021)
Entity Number: 000-868-189
Register Number: 000868189
ZIP code: 36278 (Companies in Randolph, 36278)
County: Randolph
Place of Formation: Alabama
Registered Office Street Address: 1258 S. MAIN STREET SUITE 1 & 2WEDOWEE, AL 36278
Registered Office Mailing Address: 1258 S. MAIN STREET SUITE 3 & 4WEDOWEE, AL 36278

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033782701 2021-07-21 2021-07-21 1258 MAIN ST S STE 3&4, WEDOWEE, AL, 362787180, US 1258 MAIN ST S STE 3&4, WEDOWEE, AL, 362787180, US

Contacts

Phone +1 256-357-1077
Fax 2563571078

Authorized person

Name PAMELA P VAN ETTEN
Role ADMINISTRATOR
Phone 3347995853

Taxonomy

Taxonomy Code 261QP2000X - Physical Therapy Clinic/Center
Is Primary Yes

Agent

Name Role
Blair, Jared M Agent

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State