| Name: | Mind & Body Family Practice and Behavioral Health LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 Nov 2022 (2 years ago) (Companies founded in November 2022) |
| Entity Number: | 001-050-919 |
| Register Number: | 001050919 |
| ZIP code: | 35757 (Companies in Madison, 35757) |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Mailing Address: | 133 Bridgefield RoadMadison, AL 35758 |
| Principal Address: | 7519 Wall Triana HighwayMadison, AL 35757 |
| Principal Mailing Address: | PO Box 2024Madison, AL 35758 |
| Registered Office Street Address: | 100 Jetplex Blvd SWHuntsville, AL 35824 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457062200 | 2022-12-12 | 2023-01-23 | PO BOX 2024, MADISON, AL, 357585414, US | 7519 WALL TRIANA HWY, MADISON, AL, 357578327, US | |||||||||||||||
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| Phone | +1 256-696-5895 |
| Fax | 2566965404 |
Authorized person
| Name | TONIA BODDIE |
| Role | OWNER |
| Phone | 2566965895 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Butler, Tonia P Butler | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
