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Wild Oak Wellness PC

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Company Details

Name: Wild Oak Wellness PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 11 Jan 2022 (3 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 4561678
Place of Formation: IDAHO
File Number: 799754
ZIP code: 83814
County: Kootenai County
Mailing Address: DR. DAVID CAMPBELL 4940 S GREENSFERRY RD COEUR D ALENE, ID 83814-7880

Agent

Name Role Address
David M Campbell Agent 4940 S GREENSFERRY RD, COEUR D ALENE, ID 83814

President

Name Role Address Appointed On
David M Campbell President 4940 S GREENSFERRY RD, COEUR D ALENE, ID 83814 2023-03-02

National Provider Identifier

NPI Number:
1942950274
Certification Date:
2022-03-28

Authorized Person:

Name:
DR. DAVID MICHAEL CAMPBELL
Role:
ACUPUNCTURIST
Phone:

Taxonomy:

Selected Taxonomy:
171100000X - Acupuncturist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006110460 2025-02-15
Application for Reinstatement 0005791799 2024-06-28
Dissolution/Revocation - Administrative 0005707390 2024-04-30
Annual Report 0005130986 2023-03-02
Initial Filing 0004561678 2022-01-11

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Date of last update: 17 Jun 2025

Sources: Idaho Secretary of State