| Name: | Pain and Headache Center, LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 22 Mar 2013 (12 years ago) |
| Entity Number: | 10011620 |
| ZIP code: | 99654 |
| County: | Matanuska Susitna |
| Place of Formation: | ALASKA |
| Address: | 851 WEST DRIVE, SUITE B6, WASILLA, AK 99654 |
| Mailing Address: | 4108 MATTISON AVENUE, FORT WORTH, TX 76107 |
| Supporting healthcare providers fighting with COVID-19: | $23,798 |
Line of Business
62 Health Care and Social AssistanceNAICS
621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)| Name | Role |
|---|---|
| Robert Balch | Member |
| Joshua Balch | Member |
| PETER DIEMER | Registered Agent |
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 988815 | Business License | Active | 2013-04-08 | 2024-12-04 | 2026-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| 159380 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2020-03-25 | 2020-03-25 | - |
Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
