SPACE COAST CHIROPRACTIC, INC
Medical Practice at Wickham Rd, Melbourne, FL

License number
Florida 1737
Issued Date
Jul 19, 2002
Effective Date
Sep 15, 2004
Expiration Date
Jul 19, 2004
Category
Health Care
Type
Health Care Clinic Registration
Address
Address
1070 S Wickham Rd, Melbourne, FL 32904
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

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SPACE COAST CHIROPRACTIC, INC

1070 S Wickham Rd, Melbourne, FL 32904

Status:
Inactive
Doing business as:
Space Coast Chiropractic
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Apr 9, 2001
Inactive since:
Sep 23, 2011
State ID:
P01000035869
Business type:
Florida Profit Corporation
Treasurer, President, Vice Presidents:
Kimmie L. Coley (Chiropractor),Richard Stork Principal, President, inactive, 4170 Carolwood Dr, Melbourne, FL 32934 (Physical),Jody A Stork Treasurer, President, Vice President, inactive, 4170 Carolwood Dr, Melbourne, FL 32934 (Physical)
EIN:
59-3730923

SPACE COAST CHIROPRACTIC, INC

800 E Melbourne Ave, Melbourne, FL 32901

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Nov 18, 1991
Inactive since:
Oct 9, 1992
State ID:
S95222
Business type:
Florida Profit Corporation
Treasurer, Director, Vice Presidents:
John Roberts President, Secretary, Director, inactive, 800 E Melbourne Ave, Melbourne, FL (Physical),Ronald Gold Treasurer, Director, Vice President, inactive, 800 E Melbourne Ave, Melbourne, FL (Physical)
Agent:
Roberts, John,800 E Melbourne Ave, Melbourne, FL 32901 (Physical)
EIN:
00-0000000

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