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Hometown Physical Therapy PLLC

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Company Details

Name: Hometown Physical Therapy PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 27 Oct 2020 (5 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 4042378
Place of Formation: IDAHO
File Number: 731514
ZIP code: 83402
County: Bonneville County
Principal Address: 1000 RIVER WALK DR IDAHO FALLS, ID 83402
Mailing Address: PO BOX 51330 IDAHO FALLS, ID 83405-1330

Agent

Name Role Address
Chad Simmons Agent 1000 RIVER WALK DR, IDAHO FALLS, ID 83402

Member

Name Role Address Appointed On
Chad Simmons Member PO BOX 51330, IDAHO FALLS, ID 83405 2021-09-03

National Provider Identifier

NPI Number:
1790380822
Certification Date:
2023-04-03

Authorized Person:

Name:
CHAD SIMMONS
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

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

Contacts:

Fax:
2089004408

Filing

Filing Name Filing Number Filing date
Annual Report 0005886239 2024-09-05
Annual Report 0005412288 2023-09-27
Annual Report 0004883983 2022-09-05
Annual Report 0004401716 2021-09-03
Initial Filing 0004042378 2020-10-27

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Date of last update: 15 Jun 2025

Sources: Idaho Secretary of State