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Broadway Spinal Care, LLC

Details

Name: Broadway Spinal Care, LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 11 Jan 2022 (3 years ago) (Companies founded in January 2022)
Entity Number: 000-961-009
Register Number: 000961009
ZIP code: 35150 (Companies in Talladega, 35150)
County: Talladega
Place of Formation: Alabama
Registered Office Street Address: 211 N. Broadway Ave.Sylacauga, AL 35150

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639891898 2022-09-14 2022-09-14 211 N BROADWAY AVE, SYLACAUGA, AL, 351502525, US 211 N BROADWAY AVE, SYLACAUGA, AL, 351502525, US

Contacts

Phone +1 256-861-8546

Authorized person

Name TARA E DOUGLAS
Role PARTNER
Phone 2568618546

Taxonomy

Taxonomy Code 261QH0100X - Health Service Clinic/Center
Is Primary Yes

Agent

Name Role
Douglas, Tara Agent

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State