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Trevor Baker Physical Therapy, PLLC

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Company Details

Name: Trevor Baker Physical Therapy, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 Jul 2020 (5 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 3940132
Place of Formation: IDAHO
File Number: 717504
ZIP code: 83341
County: Twin Falls County
Principal Address: 3463 E 3890 N KIMBERLY, ID 83341
Mailing Address: 3463 E 3890 N KIMBERLY, ID 83341-5508

Agent

Name Role Address
Trevor J Baker Agent 3463 E 3890 N, KIMBERLY, ID 83341

Manager

Name Role Address Appointed On Resigned On
MicKenie Baker Manager 3463 E 3890 N, KIMBERLY, ID 83341 2023-08-03 2024-07-03
Trevor Baker Manager 3463 E 3890 N, KIMBERLY, ID 83341 2021-10-21 No data

National Provider Identifier

NPI Number:
1235743436
Certification Date:
2020-11-24

Authorized Person:

Name:
DR. TREVOR JOHN BAKER
Role:
OWNER / DOCTOR OF PHYSICAL THERAPY
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
2251C2600X - Cardiopulmonary Physical Therapist
Is Primary:
No
Selected Taxonomy:
2251G0304X - Geriatric Physical Therapist
Is Primary:
No
Selected Taxonomy:
2251N0400X - Neurology Physical Therapist
Is Primary:
No
Selected Taxonomy:
2251S0007X - Sports Physical Therapist
Is Primary:
No

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006301617 2025-06-05
Annual Report 0005797092 2024-07-03
Annual Report 0005344198 2023-08-03
Annual Report 0004822315 2022-07-14
Application for Reinstatement 0004457349 2021-10-21

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Date of last update: 17 Aug 2025

Sources: Idaho Secretary of State