| Entity Name: | PERRY CHIROPRACTIC CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Dec 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Oct 2014 (10 years ago) |
| Document Number: | P98000101997 |
| FEI/EIN Number | 59-2538205 |
| Address: | 305 N. ORANGE ST., PERRY, FL, 32347 |
| Mail Address: | 305 N. ORANGE ST., PERRY, FL, 32347 |
| ZIP code: | 32347 |
| County: | Taylor |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184871667 | 2008-08-26 | 2016-05-19 | 305 N ORANGE ST, PERRY, FL, 323472726, US | 305 N ORANGE ST, PERRY, FL, 323472726, US | |||||||||||||||||||||||||
|
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| Phone | +1 850-584-7117 |
| Fax | 8505847119 |
Authorized person
| Name | DR. LEE STEVEN NELSEN |
| Role | CEO |
| Phone | 8505847117 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | CH4181 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005448400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NELSEN LEE SD.C. | Agent | 305 N. ORANGE ST., PERRY, FL, 32347 |
| Name | Role | Address |
|---|---|---|
| NELSEN LEE S | Director | 309 N. Orange St., PERRY, FL, 32347 |
| Name | Role | Address |
|---|---|---|
| NELSEN REBECCA | Manager | 309 N. Orange St., PERRY, FL, 32347 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2014-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-03-30 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-04-08 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
