| Name: | Select Provider Networks, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Exists |
| Date of registration: | 20 Oct 1997 (27 years ago) |
| Entity Number: | 000-025-855 |
| Register Number: | 000025855 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 4714 GETTYSBURG ROADMECHANICSBURG, PA 17055 |
| Registered Office Street Address: | 25 COURT STREET, SUITE 200MONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710120423 | 2009-04-10 | 2019-04-25 | 500 RIVERHILLS BUSINESS PARK STE 500, BIRMINGHAM, AL, 352425039, US | 500 RIVERHILLS BUSINESS PARK STE 500, BIRMINGHAM, AL, 352425039, US | |||||||||||||||
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| Phone | +1 205-995-5668 |
| Fax | 2059955023 |
Authorized person
| Name | MICHAEL E. TARVIN |
| Role | VICE PRESIDENT |
| Phone | 7179721100 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| FRITZ, MICHAEL A SR. | Agent |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
