| Name: | Revitalize Chiropractic and Sport LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Jan 2022 (3 years ago) |
| Entity Number: | 000-963-647 |
| Register Number: | 000963647 |
| County: | Calhoun |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 314 Monger StreetOxford, AL 36203 |
| Registered Office Street Address ZIP Code: | 36203 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629828157 | 2024-03-26 | 2024-03-26 | 14814 IMPERIAL DR, ATHENS, AL, 356137456, US | 27453 CAPSHAW RD STE E, ATHENS, AL, 356137565, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 256-343-4493 |
Authorized person
| Name | DR. TRINA CLARK |
| Role | DOCTOR/OWNER |
| Phone | 2563434493 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Clark, Trina G Clark | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
