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Life Transformation Medical Center, LLC

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Company Details

Name: Life Transformation Medical Center, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 15 Jan 2016 (9 years ago)
Business ID: 1083559
ZIP code: 38821
County: Monroe
State of Incorporation: MISSISSIPPI
Principal Office Address: 806 Earl Frye BlvdAmory, MS 38821

Agent

Name Role Address
Laura L Washington MD Agent 806 Earl Frye Blvd, Amory, MS 38821

Member

Name Role Address
Laura L Washington MD Member 806 Earl Frye Blvd, Amory, MS 38821

National Provider Identifier

NPI Number:
1558728469

Authorized Person:

Name:
MRS. CRISSY HARMON
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6622572083

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2019-11-22 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2019-08-22 Notice to Dissolve/Revoke
Annual Report LLC Filed 2018-08-10 Annual Report For Life Transformation Medical Center, LLC
Annual Report LLC Filed 2017-08-16 Annual Report For Life Transformation Medical Center, LLC
Formation Form Filed 2016-01-15 Formation For Life Transformation Medical Center, LLC

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Date of last update: 16 May 2025

Sources: Company Profile on Mississippi Secretary of State Website