| Name: | Integrated Wound Care Alabama, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 01 Oct 2020 (4 years ago) |
| Entity Number: | 000-649-895 |
| Register Number: | 000649895 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 641 South Lawrence StreetMontgomery, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568059137 | 2020-12-29 | 2020-12-29 | 492C CEDAR LN STE 514, TEANECK, NJ, 076661713, US | 641 S LAWRENCE ST, MONTGOMERY, AL, 361045809, US | |||||||||||||
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| Phone | +1 732-451-4318 |
Authorized person
| Name | DIANE LUSAS |
| Role | MEMBER |
| Phone | 2018701194 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Corporation Service Company Inc. | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
