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Carolee M Cutler Peck MD MPH OPRS, PLLC

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Company Details

Name: Carolee M Cutler Peck MD MPH OPRS, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Aug 2020 (5 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 3977022
Place of Formation: IDAHO
File Number: 722618
ZIP code: 83406
County: Bonneville County
Mailing Address: PO BOX 50678 IDAHO FALLS, ID 83405-0678
Principal Address: 3365 CHASEWOOD DRIVE AMMON, ID 83406

Agent

Name Role Address
Timothy C Peck Agent 3530 SYCAMORE CIRCLE, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On
Carolee M Cutler Peck Manager 3530 SYCAMORE CIRCLE, IDAHO FALLS, ID 83402 2021-08-19

National Provider Identifier

NPI Number:
1821741323
Certification Date:
2023-04-18

Authorized Person:

Name:
DR. CAROLEE MARIE CUTLER PECK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
4357547265
Fax:
2082280077

Filing

Filing Name Filing Number Filing date
Amendment to Certificate 0005955757 2024-11-05
Annual Report 0005868535 2024-08-22
Annual Report 0005444818 2023-10-19
Amendment to Certificate 0005183664 2023-04-12
Amendment to Certificate 0005030050 2022-12-15

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Date of last update: 14 Jun 2025

Sources: Idaho Secretary of State