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Wray Dermatology PLLC
Company Details
| Name: |
Wray Dermatology PLLC |
| Jurisdiction: |
Idaho |
| Legal type: |
Limited Liability Company (D) |
| Status: |
Active-Existing
|
| Date of registration: |
09 Feb 2024 (a year ago)
|
| Financial Date End: |
28 Feb 2026 |
| Entity Number: |
5595209 |
| Place of Formation: |
IDAHO |
| File Number: |
920551 |
| ZIP code: |
83221
|
| County: |
Bingham County |
| Principal Address: |
ADAM WRAY 1B 1350 PARKWAY DRIVE BLACKFOOT, ID 83221 |
| Mailing Address: |
ADAM WRAY 101 326 POPLAR ST BLACKFOOT, ID 83221-1741 |
Agent
| Name |
Role |
Address |
|
ADAM WRAY
|
Agent
|
148 N 200 E, BLACKFOOT, ID 83221
|
Managing Member
| Name |
Role |
Address |
Appointed On |
|
Adam D Wray
|
Managing Member
|
148 N 200 E, BLACKFOOT, ID 83221
|
2025-01-17
|
National Provider Identifier
Certification Date:
2024-07-16
Authorized Person:
Taxonomy:
Selected Taxonomy:
207N00000X - Dermatology Physician
Contacts:
This company hasn't received any reviews.
Date of last update: 22 May 2025
Sources:
Idaho Secretary of State
