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EASTERN IDAHO CHIROPRACTIC CLINIC, P.A.

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Company Details

Name: EASTERN IDAHO CHIROPRACTIC CLINIC, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 29 Jun 1995 (30 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 342432
Place of Formation: IDAHO
File Number: 342432
ZIP code: 83404
County: Bonneville County
Mailing Address: 2585 CHANNING WAY IDAHO FALLS, ID 83404-7516

Agent

Name Role Address
LARRY DEAN NELSON DC Agent 2585 CHANNING WY, IDAHO FALLS, ID 83404

President

Name Role Address Appointed On
Larry D Nelson President 4824 E MAJESTIC VIEW DR, IDAHO FALLS, ID 83406 2021-07-12

Treasurer

Name Role Address Appointed On Resigned On
Melanie W Nelson Treasurer 4824 E MAJESTIC VIEW DR, IDAHO FALLS, ID 83406 2024-05-03 2024-05-03

National Provider Identifier

NPI Number:
1588732523

Authorized Person:

Name:
DR. LARRY DEAN NELSON
Role:
CHIROPRACTIC NATUROPATHIC MEDICAL
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
2085236051

Filing

Filing Name Filing Number Filing date
Annual Report 0006258856 2025-05-17
Annual Report 0005722502 2024-05-03
Annual Report 0005222375 2023-05-03
Annual Report 0004727770 2022-05-03
Annual Report 0004345213 2021-07-12

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Date of last update: 19 Jul 2025

Sources: Idaho Secretary of State