| Name: | MW Wellness XVII, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 07 Dec 2012 (12 years ago) |
| Entity Number: | 000-868-262 |
| Register Number: | 000868262 |
| County: | Elmore |
| Place of Formation: | Florida |
| Principal Address: | 509 S. Hyde Park AveTampa, FL 33606 |
| Registered Office Street Address: | 4037 US Hwy 231, Suite Awetumpka, AL 36093 |
| Registered Office Street Address ZIP Code: | 36093 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356723563 | 2015-06-24 | 2023-06-26 | 509 S HYDE PARK AVE, TAMPA, FL, 336062266, US | 4407 OLD SHELL RD STE D, MOBILE, AL, 366081924, US | |||||||||||||||||||
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| Phone | +1 813-228-6334 |
| Fax | 8132286763 |
Authorized person
| Name | JODI DESPOY |
| Role | MANAGER |
| Phone | 8132286334 |
Taxonomy
| Taxonomy Code | 207QB0002X - Obesity Medicine (Family Medicine) Physician |
| License Number | BL007515-01-2015 |
| State | SC |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Incorp Services, Inc. | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
