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Alabama Developmental and Diagnostic Clinic LLC

Details

Name: Alabama Developmental and Diagnostic Clinic LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 14 Nov 2022 (2 years ago) (Companies founded in November 2022)
Entity Number: 001-049-263
Register Number: 001049263
ZIP code: 36303 (Companies in Houston, 36303)
County: Houston
Place of Formation: Alabama
Registered Office Street Address: 212 W. Troy St. STE BDothan, AL 36303

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346946308 2023-02-01 2023-02-01 105 APPLETON LN, MADISON, AL, 357564162, US 105 APPLETON LN, MADISON, AL, 357564162, US

Contacts

Phone +1 563-424-0459

Authorized person

Name DR. MARC A HULTQUIST
Role OWNER
Phone 5634240459

Taxonomy

Taxonomy Code 261QM2500X - Medical Specialty Clinic/Center
Is Primary Yes

Agent

Name Role Address
Northwest Registered Agent Service, Inc. Agent 212 W. Troy St. STE BDothan, AL 36303

Organizer

Name Role Address
Noble, Morgan Organizer 212 W. Troy St. STE BDothan, AL 36303

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State