| Entity Name: | MOTION WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Jan 2023 (2 years ago) |
| Document Number: | L23000018498 |
| FEI/EIN Number | 92-2047129 |
| Address: | 510 SW 5th Terrace Suite #B, Williston, FL 32696 |
| Mail Address: | 510 SW 5th Terrace Suite #B, Williston, FL 32696 |
| ZIP code: | 32696 |
| County: | Levy |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992483010 | 2023-07-10 | 2023-07-10 | 510 SW 5TH TER # B, WILLISTON, FL, 326962548, US | 510 SW 5TH TER # B, WILLISTON, FL, 326962548, US | |||||||||||||||||||
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| Phone | +1 352-528-5433 |
Authorized person
| Name | DR. RICHARD J FONTAINE III |
| Role | CEO/OWNER |
| Phone | 4016413421 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1851660617 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FONTAINE, RICHARD J, III | Agent | 510 SW 5th Terrace Suite #B, Williston, FL 32696 |
| Name | Role | Address |
|---|---|---|
| FONTAINE, MEGAN E | Manager | 6740 NW 48TH TERR., OCALA, FL 34482 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-25 | 510 SW 5th Terrace Suite #B, Williston, FL 32696 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-25 | 510 SW 5th Terrace Suite #B, Williston, FL 32696 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-25 | 510 SW 5th Terrace Suite #B, Williston, FL 32696 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| Florida Limited Liability | 2023-01-09 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
