| Name: | Jasper Dermatology LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Aug 2024 (5 months ago) |
| Entity Number: | 001-149-623 |
| Register Number: | 001149623 |
| ZIP code: | 35501 |
| County: | Walker |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 87 19th St W Ste 200Jasper, AL 35501 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801622642 | 2024-09-09 | 2024-09-09 | PO BOX 290, JASPER, AL, 355020290, US | 87 19TH ST W STE 200, JASPER, AL, 355015430, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 205-282-1802 |
Authorized person
| Name | DANA MCCULLAR |
| Role | CRNP/OWNER/CEO |
| Phone | 2052821802 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| McCullar, Dana | Agent |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
