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MOBILE SPORT REHAB WELLNESS LLC

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Company Details

Legal Name: MOBILE SPORT REHAB WELLNESS LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: July 23rd 2019
Expiration date: 31 Jul 2025
UBI Number: 604 488 377
ZIP code: 98059
City: Renton
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 4444 NE SUNSET BLVD, SUITE #2, RENTON, WA, 98059, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 1555 ANACORTES AVE NE, A204, RENTON, WA, 98059, UNITED STATES

Contact Details

E-Mail: DR.DINGRAM@GMAIL.COM
Phone Number: +1 425-919-8700

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
DAVID INGRAM Registered Agent 1555 ANACORTES AVE NE APT A204, RENTON, WA, 98059-3978, UNITED STATES

Key Officers & Management

Name Role Address
DAVID INGRAM Executor 1555 ANACORTES AVE NE APT A204, RENTON, WA, 98059-3978, UNITED STATES
DAVID INGRAM Governing Person 1555 ANACORTES AVE NE APT A204, RENTON, WA, 98059, UNITED STATES

National Provider Identifier

NPI Number:
1770153546
Certification Date:
2021-06-24

Authorized Person:

Name:
DAVID INGRAM
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

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