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Teton Dietetics, LLC

Teton Dietetics, LLC

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Company Details

Name:	Teton Dietetics, LLC
Jurisdiction:	Idaho
Legal type:	Limited Liability Company (D)
Status:	Active-Existing
Date of registration:	09 Aug 2022 (3 years ago)
Financial Date End:	31 Aug 2025
Entity Number:	4854728
Place of Formation:	IDAHO
File Number:	835398
ZIP code:	83455
County:	Teton County
Principal Address:	680 E 5500 S VICTOR, ID 83455
Mailing Address:	680 E 5500 S VICTOR, ID 83455-4613

Agent

Name	Role	Address
Alexy V Nelson	Agent	680 E 5500 S, VICTOR, ID 83455

Manager

Name	Role	Address	Appointed On
Alexy V Nelson	Manager	680 E 5500 S, VICTOR, ID 83455	2023-09-09

National Provider Identifier

NPI Number:

1851173561

Certification Date:

2023-10-17

Link:

View on NPI website

Authorized Person:

Name:

ALEXY V NELSON

Role:

OWNER

Phone:

2082704306

Taxonomy:

Selected Taxonomy:

133V00000X - Registered Dietitian

Is Primary:

Yes

Contacts:

Phone:

+1 208-270-4306

Filing

Filing Name	Filing Number	Filing date
Annual Report	0005814885	2024-07-09
Annual Report	0005394635	2023-09-09
Initial Filing	0004854728	2022-08-09

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Date of last update: 25 Mar 2025

Sources: Idaho Secretary of State