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LAKE CITY PHYSICAL THERAPY, P.A.

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Company Details

Name: LAKE CITY PHYSICAL THERAPY, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 12 Feb 1996 (29 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 349946
Place of Formation: IDAHO
File Number: 349946
ZIP code: 83835
County: Kootenai County
Mailing Address: PO BOX 1180 HAYDEN, ID 83835

Agent

Name Role Address
SHEREE L DIBIASE Agent 14953 E. HAYDEN LAKE RD, HAYDEN LAKE, ID 83835

President

Name Role Address Appointed On
Sheree DiBIase President 2170 IRONWOOD CENTER DR., COEUR D ALENE, ID 83814 2021-02-16

Secretary

Name Role Address Appointed On Resigned On
Greg Schneider Secretary 2170 IRONWOOD CENTER DR., COEUR D ALENE, ID 83814 2024-01-21 2024-01-21

National Provider Identifier

NPI Number:
1952521411
Certification Date:
2024-08-01

Authorized Person:

Name:
SHEREE LYNN DIBIASE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
2087655654

Filing

Filing Name Filing Number Filing date
Annual Report 0006119735 2025-02-22
Annual Report 0005567443 2024-01-21
Annual Report 0005064481 2023-01-13
Annual Report 0004571510 2022-01-14
Annual Report 0004175627 2021-02-16

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Date of last update: 29 Jun 2025

Sources: Idaho Secretary of State