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KENTUCKY MEDICAL SPA, PLLC

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Company Details

Name: KENTUCKY MEDICAL SPA, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 12 Aug 2009 (16 years ago)
Organization Date: 12 Aug 2009 (16 years ago)
Managed By: Members
Organization Number: 0736651
ZIP code: 41240
City: Paintsville, Nippa, Offutt, Swamp Branch, Thealka, Wh...
Primary County: Johnson County
Principal Office: 236 COLLEGE STREET, SUITE 1, PAINTSVILLE, KY 41240
Place of Formation: KENTUCKY

Registered Agent

Name Role
DUSTIN DEVERS Registered Agent

Organizer

Name Role
DUSTIN DEVERS Organizer

National Provider Identifier

NPI Number:
1326440637

Authorized Person:

Name:
DR. JERRY BRACKETT
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6067881045

Filings

Name File Date
Dissolution 2010-04-28
Articles of Organization (LLC) 2009-08-12

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Sources: Kentucky Secretary of State