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ELLENSBURG SPORT AND SPINE LLC

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Company Details

Legal Name: ELLENSBURG SPORT AND SPINE LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: July 1st 2021
Expiration date: 31 Jul 2026
UBI Number: 604 775 270
ZIP code: 98926
City: Ellensburg
County: KITTITAS
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 314 N PINE ST, ELLENSBURG, WA, 98926-3366, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 314 N PINE ST, ELLENSBURG, WA, 98926, UNITED STATES

Contact Details

E-Mail: DRCLARK@CLARKCHIROELLENSBURG.COM
Phone Number: +1 509-312-3000

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
DILLON CLARK Registered Agent 314 N PINE ST, ELLENSBURG, WA, 98926-3366, UNITED STATES

Key Officers & Management

Name Role Address
DILLON CLARK Executor 301 W 2ND AVE, ELLENSBURG, WA, 98926-3014, UNITED STATES
DILLON CLARK Governing Person 301 W 2ND AVE, ELLENSBURG, WA, 98926-3014, UNITED STATES

National Provider Identifier

NPI Number:
1376215483
Certification Date:
2022-05-06

Authorized Person:

Name:
DR. DILLON T CLARK
Role:
OWNER/AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

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