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Metta Physical Therapy, PLLC

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Company Details

Name: Metta Physical Therapy, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 10 Mar 2019 (6 years ago)
Financial Date End: 31 Mar 2025
Date dissolved: 03 Feb 2025
Entity Number: 3446843
Place of Formation: IDAHO
File Number: 657797
ZIP code: 83841
County: Bonner County
Principal Address: ALI LORAINE, DPT, OMS 197 LACLEDE SHORES DRIVE LACLEDE, ID 83841
Mailing Address: ALICE LORAINE, DPT, OMS STE F 642 N TRIANGLE DR PONDERAY, ID 83852-9609

Agent

Name Role Address
Alice Loraine Agent 197 LACLEDE SHORES DRIVE, LACLEDE, ID 83841

Manager

Name Role Address Appointed On
Alice Loraine DPT, OMS Manager PO BOX 322, LACLEDE, ID 83841 2021-02-06

National Provider Identifier

NPI Number:
1366151086
Certification Date:
2022-12-07

Authorized Person:

Name:
ALICE LORAINE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2089465364

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0006093876 2025-02-03
Annual Report 0005686483 2024-04-09
Statement of Change of Business Mailing Address 0005682854 2024-04-07
Annual Report 0005098368 2023-02-06
Statement of Change of Business Mailing Address 0005013149 2022-12-05

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Date of last update: 17 May 2025

Sources: Idaho Secretary of State