| Name: | ACCIDENT SPINE & REHAB, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 08 Mar 2012 (13 years ago) |
| Entity Number: | 000-044-482 |
| Register Number: | 000044482 |
| ZIP code: | 35406 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 5945 KNIGHT AVENUETUSCALOOSA, AL 35406 |
| Authorized Capital: | 10,000 @ $1 PV |
Activities
ENGAGE IN MULTIPLE DISCIPLINARY SPINAL CARE/REHABILITATION
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649691858 | 2013-12-16 | 2015-08-20 | 819 MIMOSA PARK RD, TUSCALOOSA, AL, 354054839, US | 1401 3RD AVE W, SUITE 108, BIRMINGHAM, AL, 352085300, US | |||||||||||||||||||
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| Phone | +1 205-561-6015 |
| Fax | 2059576740 |
Authorized person
| Name | DR. BRENT ALAN TIDWELL |
| Role | PRESIDENT |
| Phone | 2055616015 |
Taxonomy
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | 2100 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TIDWELL, BRENT | Agent | 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405 |
| Name | Role | Address |
|---|---|---|
| TIDWELL, BRENT | Incorporator | 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405 |
| Name | Role | Address |
|---|---|---|
| TIDWELL, BRENT | Director | 819 MIMOSA PARK ROADTUSCALOOSA, AL 35405 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8758557006 | 2020-04-08 | 0459 | PPP | 819 MIMOSA PARK RD, TUSCALOOSA, AL, 35405-4839 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
