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Elevate PT LLC

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Company Details

Name: Elevate PT LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 07 Sep 2022 (3 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 4889031
Place of Formation: IDAHO
File Number: 839798
ZIP code: 83201
County: Bannock County
Principal Address: 7650 WEST POCATELLO CREEK ROAD POCATELLO, ID 83201
Mailing Address: 7650 W POCATELLO CREEK RD POCATELLO, ID 83201-9038

Agent

Name Role Address
Trina M Hall Agent 7650 W POCATELLO CREEK ROAD, POCATELLO, ID 83201

Member

Name Role Address Appointed On
Trina M Hall Member 7650 W POCATELLO CREEK ROAD, POCATELLO, ID 83201 2023-08-28

National Provider Identifier

NPI Number:
1730803362
Certification Date:
2023-10-09

Authorized Person:

Name:
JILL M BRIGHT
Role:
BUSINESS OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005944314 2024-10-17
Annual Report 0005373017 2023-08-28
Initial Filing 0004889031 2022-09-07

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Date of last update: 18 Jun 2025

Sources: Idaho Secretary of State