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DuPont Wellness PLLC

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Company Details

Name: DuPont Wellness PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Oct 2020 (5 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 4031634
Place of Formation: IDAHO
File Number: 729707
ZIP code: 83712
County: Ada County
Principal Address: COREY DUPONT 910 E WASHINGTON ST BOISE, ID 83712-7321

Agent

Name Role Address
Corey DuPont Agent 910 E WASHINGTON ST, BOISE, ID 83712

Manager

Name Role Address Appointed On Resigned On
Corey DuPont Manager 910 E WASHINGTON ST, BOISE, ID 83712 2021-09-07 No data
Amanda DuPont Manager 505 W IDAHO ST, BOISE, ID 83702 2023-09-06 2023-09-06

National Provider Identifier

NPI Number:
1861254278
Certification Date:
2024-04-26

Authorized Person:

Name:
DR. COREY DUPONT
Role:
OWNER, PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2082526297

Filing

Filing Name Filing Number Filing date
Annual Report 0005921947 2024-10-03
Statement of Change of Business Mailing Address 0005865770 2024-08-19
Amendment to Certificate 0005865771 2024-08-19
Statement of Change of Business Mailing Address 0005507731 2023-12-11
Annual Report 0005385511 2023-09-06

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Date of last update: 18 May 2025

Sources: Idaho Secretary of State