| Entity Name: | CLARK CHIROPRACTIC AND WELLNESS PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Jan 2024 (a year ago) |
| Document Number: | L24000008411 |
| Address: | 709 Sebastian Blvd Suite F, Sebastian, FL 32958 |
| Mail Address: | 709 Sebastian Blvd Suite F, Sebastian, FL 32958 |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538920665 | 2024-01-16 | 2024-04-26 | 10104 AUTHORS WAY, ORLANDO, FL, 328326348, US | 709 SEBASTIAN BLVD STE F, SEBASTIAN, FL, 329588704, US | |||||||||||||||
|
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| Phone | +1 304-767-1921 |
| Phone | +1 772-202-7236 |
Authorized person
| Name | JOSHUA CLARK |
| Role | OWNER |
| Phone | 3047671921 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLARK, JOSHUA P | Agent | 10104 AUTHORS WAY, ORLANDO, FL 32832 |
| Name | Role | Address |
|---|---|---|
| CLARK, JOSHUA P | Manager | 10104 AUTHORS WAY, ORLANDO, FL 32832 |
| CRESPO DAVILA, ALEXANDRA | Manager | 10104 AUTHORS WAY, ORLANDO, FL 32832 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-10 | 709 Sebastian Blvd Suite F, Sebastian, FL 32958 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-10 | 709 Sebastian Blvd Suite F, Sebastian, FL 32958 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-03 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
