| Name: | Family Practice Specialist, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 06 Aug 2007 (17 years ago) |
| Entity Number: | 000-253-820 |
| Register Number: | 000253820 |
| County: | Colbert |
| Place of Formation: | Lauderdale County |
| Principal Address: | MUSCLE SHOALS, AL |
| Registered Office Street Address: | 203 W AVALON AVE STE 390MUSCLE SHOALS, AL 35661 |
| Registered Office Street Address ZIP Code: | 35661 |
| Authorized Capital: | 1,000 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194904284 | 2007-10-25 | 2008-02-29 | 203 AVALON AVE, SUITE 350, MUSCLE SHOALS, AL, 356612869, US | 203 AVALON AVE, SUITE 350, MUSCLE SHOALS, AL, 356612869, US | |||||||||||||||||||
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| Phone | +1 256-381-2161 |
| Fax | 2563812161 |
Authorized person
| Name | DR. KENNETH D KISER |
| Role | OWNER |
| Phone | 2563812161 |
Taxonomy
| Taxonomy Code | 173000000X - Legal Medicine |
| License Number | 10486 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| KISER, KENNETH D | Agent |
| Name | Role |
|---|---|
| CULOTTA, JAKE | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
