| Entity Name: | FORWARD PHYSIO LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 31 Jul 2023 (2 years ago) |
| Document Number: | L23000357754 |
| FEI/EIN Number | 86-3102489 |
| Address: | 9811 MAGNOLIA VIEW CT, 202, RIVERVIEW, FL 33578 |
| Mail Address: | 9811 MAGNOLIA VIEW CT, 202, RIVERVIEW, FL 33578 |
| ZIP code: | 33578 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104507169 | 2023-07-31 | 2023-08-08 | 9811 MAGNOLIA VIEW CT APT 202, RIVERVIEW, FL, 335784651, US | 9811 MAGNOLIA VIEW CT APT 202, RIVERVIEW, FL, 335784651, US | |||||||||||||
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| Phone | +1 401-688-6431 |
Authorized person
| Name | DR. NICHOLAS TANNER |
| Role | DOCTOR OF PHYSICAL THERAPY |
| Phone | 4016886431 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TANNER, NICHOLAS S, DR | Agent | 9811 MAGNOLIA VIEW CT, 202, RIVERVIEW, FL 33578 |
| Name | Role | Address |
|---|---|---|
| XU, DANNY, DR | Manager | 14605 GILLIGANS WAY APT 8, TAMPA, FL 33613 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-13 |
| Florida Limited Liability | 2023-07-31 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
