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Marrowbone Family Clinic, PLLC

Company Details

Name: Marrowbone Family Clinic, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 13 Apr 2012 (13 years ago)
Organization Date: 13 Apr 2012 (13 years ago)
Last Annual Report: 09 Sep 2013 (12 years ago)
Managed By: Members
Organization Number: 0826827
ZIP code: 41559
City: Regina
Primary County: Pike County
Principal Office: 10363 Regina Belcher Hwy, Regina, KY 41559
Place of Formation: KENTUCKY

Registered Agent

Name Role
Kim Justice Registered Agent

Member

Name Role
Kim Justice Member

Organizer

Name Role
Kim Justice Organizer
Antoinette Justice Organizer

National Provider Identifier

NPI Number:
1831444629

Authorized Person:

Name:
MR. KIM JUSTICE
Role:
MANAGER
Phone:

Taxonomy:

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

Contacts:

Assumed Names

Name Status Expiration Date
RUSSELL FORK CLINIC Inactive 2018-01-03

Filings

Name File Date
Administrative Dissolution 2014-09-30
Annual Report 2013-09-09
Certificate of Assumed Name 2013-01-03

Sources: Kentucky Secretary of State