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BOISE PODIATRY CLINIC, P.A.

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Company Details

Name: BOISE PODIATRY CLINIC, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 06 Sep 1974 (51 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 161911
Place of Formation: IDAHO
File Number: 161911
ZIP code: 83713
County: Ada County
Mailing Address: GARY MILLWARD 5174 N MAIDSTONE WAY BOISE, ID 83713

Agent

Name Role Address
Gary Millward Agent 5174 N MAIDSTONE WAY, BOISE, ID 83713

Secretary

Name Role Address Appointed On
Gary Millward Secretary 1828 SOUTH MILLENNIUM WAY #100, MERIDIAN, ID 83642 2020-08-03

President

Name Role Address Appointed On
Gary Millward President 5174 N MAIDSTONE WAY, BOISE, ID 83713 2024-08-07

National Provider Identifier

NPI Number:
1982711578

Authorized Person:

Name:
DR. GARY J MILLWARD
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
213EP1101X - Primary Podiatric Medicine Podiatrist
Is Primary:
Yes

Contacts:

Fax:
2089384675

Filing

Filing Name Filing Number Filing date
Annual Report 0005851749 2024-08-07
Annual Report 0005354302 2023-08-06
Annual Report 0004850494 2022-08-05
Annual Report 0004365343 2021-08-03
Annual Report 0003952921 2020-08-03

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Date of last update: 28 May 2025

Sources: Idaho Secretary of State