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IDAHO NEUROSURGERY & SPINE, PLLC

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Company Details

Name: IDAHO NEUROSURGERY & SPINE, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 25 Jul 2014 (11 years ago)
Financial Date End: 31 Jul 2021
Date dissolved: 28 Dec 2020
Entity Number: 428180
Place of Formation: IDAHO
File Number: 428180
ZIP code: 83404
County: Bonneville County
Principal Address: 3345 POTOMAC WAY IDAHO FALLS, ID 83404
Mailing Address: 3345 POTOMAC WAY IDAHO FALLS, ID 83404-4978

Agent

Name Role Address
DENNIS WILKINSON Agent 3480 MERLIN DR, IDAHO FALLS, ID 83401

National Provider Identifier

NPI Number:
1750787297

Authorized Person:

Name:
DR. CLARK H ALLEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207T00000X - Neurological Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2085522027

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0004102140 2020-12-28
Annual Report 0003910001 2020-06-16
Annual Report 0003532044 2019-06-05
Annual Report 0002824032 2018-05-21
Change of Registered Office/Agent/Both (by Entity) 0002824031 2017-12-07

USAspending Awards / Financial Assistance

Date:
2020-04-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
176900.00
Total Face Value Of Loan:
176900.00

Paycheck Protection Program

Date Approved:
2020-04-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
176900
Current Approval Amount:
176900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
177898.39

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Date of last update: 01 Jul 2025

Sources: Idaho Secretary of State