| Name: | Willow Pediatric Wellness LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 May 2024 (6 months ago) (Companies founded in May 2024) |
| Entity Number: | 001-136-925 |
| Register Number: | 001136925 |
| ZIP code: | 35210 (Companies in Jefferson, 35210) |
| County: | Jefferson |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 3507 Rockcliff CirMountain Brk, AL 35210 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902645021 | 2024-05-20 | 2024-05-20 | 3507 ROCKCLIFF CIR, MOUNTAIN BRK, AL, 352103030, US | 2850 CAHABA RD STE 140, MOUNTAIN BRK, AL, 352232345, US | |||||||||||||
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| Phone | +1 334-790-9546 |
Authorized person
| Name | LAURA CROCKER MITCHELL |
| Role | OWNER, PEDIATRICIAN |
| Phone | 3347909546 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Crocker Mitchell, Laura | Agent | 3507 Rockcliff Cir,Birmingham, AL 35210 |
| Name | Role | Address |
|---|---|---|
| Crocker Mitchell, Laura | Organizer | 3507 Rockcliff Cir,Birmingham, AL 35210 |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
