| Name: | Wild Physical Therapy and Wellness LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 16 Jun 2024 (7 months ago) |
| Identification Number: | 001775332 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 555 N MAIN ST #1439, PROVIDENCE, RI, 02904, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174360176 | 2024-07-09 | 2024-07-09 | 555 N MAIN ST # 1439, PROVIDENCE, RI, 029045722, US | 545 PAWTUCKET AVE # LL04A, PAWTUCKET, RI, 028606046, US | |||||||||||||
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| Phone | +1 812-662-5033 |
Authorized person
| Name | MOLLYE LEAS-MEDREK |
| Role | OWNER |
| Phone | 8126625033 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOLLYE LEAS-MEDREK | Agent | 505 FAIR ST, WARWICK, RI, 02888, USA |
| Number | Name | File Date |
|---|---|---|
| 202455781660 | Articles of Organization | 2024-06-16 |
Date of last update: 29 Oct 2024
Sources: Rhode Island Department of State
