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MOUNTAIN VALLEY IMAGING, PLLC

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Company Details

Name: MOUNTAIN VALLEY IMAGING, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 28 Nov 2008 (17 years ago)
Financial Date End: 30 Nov 2014
Date dissolved: 10 Feb 2015
Entity Number: 248610
Place of Formation: IDAHO
File Number: 0000248610
ZIP code: 83440
County: Madison County
Principal Address: 2935 NORTH 4000 WEST REXBURG, ID 83440

National Provider Identifier

NPI Number:
1578789525

Authorized Person:

Name:
DR. DAVID VICTOR HANSEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Fax:
2083563066

Filing

Filing Name Filing Number Filing date
Annual Report 0001936027 2013-11-27
Annual Report 0001936026 2012-12-20
Annual Report 0001936025 2011-12-01
Annual Report 0001936024 2010-12-21
Annual Report 0001936023 2010-01-18

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State