Search icon

LAKELAND PHYSICAL THERAPY AND SPORTS INJURIES, P.A.

Company claim

Is this your business?

Get access!

Company Details

Name: LAKELAND PHYSICAL THERAPY AND SPORTS INJURIES, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 08 Nov 1996 (29 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 359879
Place of Formation: IDAHO
File Number: 359879
Mailing Address: KATHY CAPAUL 16658 N HIGHWAY 41 RATHDRUM, ID 83858-6890

Agent

Name Role Address
JUSTIN KANE Agent 16658 N HIGHWAY 41, RATHDRUM, ID 83858

Vice President

Name Role Address Appointed On
Sky R Pruitt Vice President 16768 N HIGHWAY 41, RATHDRUM, ID 83858 2023-10-10

Secretary

Name Role Address Appointed On Resigned On
Gregory Roman Secretary 16658 N HIGHWAY 41, RATHDRUM, ID 83858 2023-10-25 No data
Kathleen M Capaul Secretary 16768 N HIGHWAY 41, RATHDRUM, ID 83858 2020-10-02 2023-10-25

President

Name Role Address Appointed On
Justin Kane President 16658 N HIGHWAY 41, RATHDRUM, ID 83858 2023-10-25

National Provider Identifier

NPI Number:
1083896674

Authorized Person:

Name:
SKY R PRUITT
Role:
PHYSICAL THERAPIST/OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
8449552492

Filing

Filing Name Filing Number Filing date
Annual Report 0005922178 2024-10-03
Annual Report Amendment 0005448718 2023-10-25
Annual Report 0005436890 2023-10-10
Annual Report 0004946248 2022-10-07
Annual Report 0004441575 2021-10-07

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 29 Jun 2025

Sources: Idaho Secretary of State