|
TD THERAPY SERVICES LLC EMPLOYEE GROUP HEALTH PLAN
|
2023
|
462728652
|
2024-08-02
|
TD THERAPY SERVICES, LLC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2023-01-01
|
| Business code |
621340
|
| Sponsor’s telephone number |
2089043311
|
| Plan sponsor’s
address |
PO BOX 235, POCATELLO, ID, 832040235
|
Signature of
| Role |
Plan administrator |
| Date |
2024-08-02 |
| Name of individual signing |
DAVID VANORDEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2024-08-02 |
| Name of individual signing |
DAVID VANORDEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
TD THERAPY SERVICES LLC EMPLOYEE GROUP HEALTH PLAN
|
2022
|
462728652
|
2023-07-31
|
TD THERAPY SERVICES, LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2022-01-01
|
| Business code |
621340
|
| Sponsor’s telephone number |
2089043311
|
| Plan sponsor’s
address |
102 S MAIN ST UNIT 235, POCATELLO, ID, 832042249
|
Signature of
| Role |
Plan administrator |
| Date |
2023-07-31 |
| Name of individual signing |
DAVID VANORDEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2023-07-31 |
| Name of individual signing |
DAVID VANORDEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
