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SOUTH LAKE CHIROPRACTIC P.C.

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Company Details

Name: SOUTH LAKE CHIROPRACTIC P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 23 Aug 2004 (21 years ago)
Entity Number: 3093890
ZIP code: 11520
County: Suffolk
Place of Formation: New York
Address: 68 E. FIRST ST., FREEPORT, NY, United States, 11520

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
C/O CARL CERRUTI, CPA DOS Process Agent 68 E. FIRST ST., FREEPORT, NY, United States, 11520

National Provider Identifier

NPI Number:
1679640775

Authorized Person:

Name:
DR. SCOTT LESLIE
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
6314224243

Filings

Filing Number Date Filed Type Effective Date
040823001070 2004-08-23 CERTIFICATE OF INCORPORATION 2004-08-23

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State