| Entity Name: | PRO ACTIVE CHIROPRACTIC GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Nov 2004 (20 years ago) |
| Document Number: | P04000155235 |
| FEI/EIN Number | 201876793 |
| Address: | 4591 E HWY 20, Niceville, FL, 32578, US |
| Mail Address: | 4591 E HWY 20, Niceville, FL, 32578, US |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780865311 | 2007-11-26 | 2020-06-08 | 4591 E HIGHWAY 20 STE 201, NICEVILLE, FL, 325788845, US | 4591 E HIGHWAY 20 STE 201, NICEVILLE, FL, 325788845, US | |||||||||||||||||||||||||
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| Phone | +1 850-279-4913 |
| Fax | 8502794975 |
Authorized person
| Name | BRIAN SCHUESSLER |
| Role | CEO |
| Phone | 8506857734 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 8262 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381477700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SCHUESSLER BRIAN L | Agent | 1069 NAPA WAY, NICEVILLE, FL, 32578 |
| Name | Role | Address |
|---|---|---|
| SCHUESSLER BRIAN L | President | 1069 NAPA WAY, NICEVILLE, FL, 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-09 | 4591 E HWY 20, STE 201, Niceville, FL 32578 | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-09 | 4591 E HWY 20, STE 201, Niceville, FL 32578 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-26 | SCHUESSLER, BRIAN L | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-03-18 |
| ANNUAL REPORT | 2015-01-09 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4967757310 | 2020-04-30 | 0491 | PPP | 4591 HIGHWAY 20, NICEVILLE, FL, 32578-8845 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
