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LIBERTY BELL FAMILY MEDICINE, PLLC

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Company Details

Legal Name: LIBERTY BELL FAMILY MEDICINE, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 28th 2022
Expiration date: 31 Oct 2025
UBI Number: 604 990 842
ZIP code: 98856
City: Twisp
County: OKANOGAN
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 214 GLOVER ST, TWISP, WA, 98856, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 918, TWISP, WA, 98856-0918, UNITED STATES

Contact Details

E-Mail: ADMIN@LIBERTYBELLFAMILYMEDICINE.COM
Phone Number: +1 509-337-5005

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
LAUREN MCCLOY Registered Agent 63 YELLOW JACKET RD, TWISP, WA, 98856-9635, UNITED STATES

Key Officers & Management

Name Role Address
THOMAS MCCLOY Executor 63 YELLOW JACKET RD, TWISP, WA, 98856-9635, UNITED STATES
THOMAS MCCLOY Governing Person -

National Provider Identifier

NPI Number:
1992403729
Certification Date:
2023-02-17

Authorized Person:

Name:
DR. THOMAS MCKELLAR MCCLOY
Role:
MD, OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5092193329
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