REALM INCORPORATED
Ambulatory Health at Main St, Dothan, AL

License number
Alabama DO190
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. SAMMY BANNER D.O.
Title: PRESIDENT
Phone: (334) 702-8872
Address
Address
1435 W Main St, Dothan, AL 36301
National Provider ID: 1558616029
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Realm, Inc

Dothan, AL

Industry:
OWN/OPERATE A MEDICAL CLINIC/PROVIDING
Registration:
Jul 17, 1995
State ID:
173-138
Business type:
Domestic Corporation
Formation place:
Lauderdale County
Incorporator:
Sam R Banner (incorporator)

Realm Corporation

Dothan, AL

Status:
Inactive
Industry:
CRAFT PRODUCTS
Registration:
May 10, 1978
State ID:
787-268
Business type:
Domestic Corporation
Formation place:
Houston County
Incorporators:
Eugene E Morris (incorporator),Richard T Lucey (incorporator),Janet A Lucey (incorporator)
Canceled Date:
Oct 27, 1981

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