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Balance Regenerative Medicine, PLLC

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Company Details

Name: Balance Regenerative Medicine, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 May 2021 (4 years ago)
Financial Date End: 31 May 2026
Entity Number: 4288383
Place of Formation: IDAHO
File Number: 764649
ZIP code: 83301
County: Twin Falls County
Principal Address: ERICA CAMERON 2175 CANDLEWOOD AVE TWIN FALLS, ID 83301
Mailing Address: ERICA CAMERON 2175 CANDLEWOOD AVE TWIN FALLS, ID 83301-8363

Agent

Name Role Address
Erica A Cameron Agent 2075 CANDLEWOOD AVE, TWIN FALLS, ID 84285-9777

Member

Name Role Address Appointed On
Erica A Cameron NP PA Member 2175 CANDLEWOOD AVE, TWIN FALLS, ID 83301 2021-10-29

National Provider Identifier

NPI Number:
1568136299
Certification Date:
2024-05-16

Authorized Person:

Name:
ERICA ANN CAMERON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
8335052716

Filing

Filing Name Filing Number Filing date
Annual Report 0006185562 2025-04-03
Annual Report 0005666586 2024-04-03
Annual Report 0005174254 2023-04-03
Amendment to Certificate 0004736340 2022-05-05
Change of Registered Office/Agent/Both (by Entity) 0004735807 2022-05-05

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Date of last update: 16 Apr 2025

Sources: Idaho Secretary of State