| Entity Name: | WHOLE HEALTH CLINIC, INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Feb 2001 (24 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 07 Dec 2001 (23 years ago) |
| Document Number: | P01000022634 |
| FEI/EIN Number | 010553453 |
| Address: | 2819 MAHAN DRIVE, SUITE 102, TALLAHASSEE, FL, 32308 |
| Mail Address: | 2819 MAHAN DRIVE, SUITE 102, TALLAHASSEE, FL, 32308 |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801921770 | 2007-02-22 | 2009-11-20 | 2819 MAHAN DRIVE, STE 102, TALLAHASSEE, FL, 32308, US | 2819 MAHAN DRIVE, STE 102, TALLAHASSEE, FL, 32308, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 850-877-8980 |
| Fax | 8506711796 |
Authorized person
| Name | DR. PERI L DWYER |
| Role | CEO/OWNER |
| Phone | 8508778980 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH5646 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 38125 |
| State | FL |
| Issuer | MEDICAID |
| Number | 380166700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Callahan Robert Dr. | Agent | 2819 MAHAN DRIVE, TALLAHASSEE, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Callahan Robert Dr. | Chief Executive Officer | 2819 Mahan Drive, TALLAHASSEE, FL, 32308 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000059897 | EX-STATIC CHIROPRACTIC | ACTIVE | 2019-05-21 | 2029-12-31 | No data | 2819 MAHAN DR., #102, TALLAHASSEE, FL, 32308 |
| G14000077043 | HEALTHSOURCE OF TALLAHASSEE | EXPIRED | 2014-07-25 | 2019-12-31 | No data | 2819 MAHAN DR #102, TALLAHASSEE, FL, 32308 |
| G08092700011 | WHOLE HEALTH CHIROPRACTIC CLINIC | EXPIRED | 2008-04-01 | 2013-12-31 | No data | 2819-102 MAHAN DRIVE, TALLAHASSEE, FL, 32308 |
| G08091700175 | CHIROACU MASSAGE | EXPIRED | 2008-03-31 | 2013-12-31 | No data | 2819-102 MAHAN DRIVE, TALLAHASSEE, FL, 32308 |
| G08091700178 | PATHWAY WELLNESS CENTER | EXPIRED | 2008-03-31 | 2013-12-31 | No data | 2819-102 MAHAN DRIVE, TALLAHASSEE, FL, 32308 |
| G08091700189 | WHOLE HEALTH CLINIC | EXPIRED | 2008-03-31 | 2013-12-31 | No data | 2819-102 MAHAN DRIVE, TALLAHASSEE, FL, 32308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2014-07-02 | Callahan, Robert, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-07-17 | 2819 MAHAN DRIVE, SUITE 102, TALLAHASSEE, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2008-07-17 | 2819 MAHAN DRIVE, SUITE 102, TALLAHASSEE, FL 32308 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-07-17 | 2819 MAHAN DRIVE, SUITE 102, TALLAHASSEE, FL 32308 | No data |
| AMENDMENT | 2001-12-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
