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KELLY D. HARRIS, D.C., P.A.

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Company Details

Name: KELLY D. HARRIS, D.C., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 17 Oct 1988 (37 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 272959
Place of Formation: IDAHO
File Number: 272959
ZIP code: 83401
County: Bonneville County
Mailing Address: STE A1 211 S WOODRUFF AVE IDAHO FALLS, ID 83401-4865

Agent

Name Role Address
KELLY D. HARRIS, D.C. Agent 211 S. WOODRUFF AVE,, SUITE A1, IDAHO FALLS, ID 83401

President

Name Role Address Appointed On
Kelly D Harris President 211 S. WOODRUFF, A-1, IDAHO FALLS, ID 83401 2021-01-19

Secretary

Name Role Address Appointed On Resigned On
Tallie S Harris Secretary 4983 TORCELLO DR, IDAHO FALLS, ID 83406 2023-10-03 2023-10-03

National Provider Identifier

NPI Number:
1174889372

Authorized Person:

Name:
DR. KELLY D HARRIS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
2085295588

Filing

Filing Name Filing Number Filing date
Annual Report 0005932045 2024-10-07
Annual Report 0005420413 2023-10-03
Annual Report 0004946103 2022-10-07
Application for Reinstatement 0004582830 2022-01-27
Dissolution/Revocation - Administrative 0004564860 2022-01-12

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$8,750
Date Approved:
2021-03-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$8,750
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$8,806.34
Servicing Lender:
Idaho Central CU
Use of Proceeds:
Payroll: $8,749
Utilities: $1
Jobs Reported:
1
Initial Approval Amount:
$8,700
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$8,700
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$8,776.99
Servicing Lender:
Idaho Central CU
Use of Proceeds:
Payroll: $8,700

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Date of last update: 18 Jul 2025

Sources: Idaho Secretary of State