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LUKE ROSEN, DO, PLLC
Company Details
| Name: |
LUKE ROSEN, DO, PLLC |
| Jurisdiction: |
Idaho |
| Legal type: |
Limited Liability Company (D) |
| Status: |
Active-Existing
|
| Date of registration: |
25 Sep 2022 (3 years ago)
|
| Financial Date End: |
30 Sep 2025 |
| Entity Number: |
4924119 |
| Place of Formation: |
IDAHO |
| File Number: |
842468 |
| ZIP code: |
83843
|
| County: |
Latah County |
| Principal Address: |
UNIT 4B 1174 ALTURAS DRIVE MOSCOW, ID 83843 |
| Mailing Address: |
1174 ALTURAS DR UNIT 4B MOSCOW, ID 83843-8341 |
Agent
| Name |
Role |
Address |
|
Luke Rosen
|
Agent
|
1174 ALTURAS DRIVE, UNIT 4B, MOSCOW, ID 83843
|
Manager
| Name |
Role |
Address |
Appointed On |
|
Luke Rosen
|
Manager
|
1174 ALTURAS DRIVE, MOSCOW, ID 83843
|
2023-08-03
|
National Provider Identifier
Certification Date:
2022-09-30
Authorized Person:
Name:
LUKE BILLMEYER ROSEN
Taxonomy:
Selected Taxonomy:
2083A0300X - Addiction Medicine (Preventive Medicine) Physician
Selected Taxonomy:
2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Contacts:
This company hasn't received any reviews.
Date of last update: 25 Mar 2025
Sources:
Idaho Secretary of State
