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Indian Creek Chiropractic PLLC

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Company Details

Name: Indian Creek Chiropractic PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 Jan 2023 (2 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 5059108
Place of Formation: IDAHO
File Number: 857468
ZIP code: 83605
County: Canyon County
Principal Address: STE 102 2523 S 10TH AVE CALDWELL, ID 83605
Mailing Address: STE 102 2523 S 10TH AVE CALDWELL, ID 83605-6760

Agent

Name Role Address
Jordan Weaver Agent 2523 S 10TH AVE, STE 102, CALDWELL, ID 83605

Member

Name Role Address Appointed On
Jordan Weaver Member 2523 S 10TH AVE, CALDWELL, ID 83605 2024-01-04

National Provider Identifier

NPI Number:
1942982822
Certification Date:
2023-08-01

Authorized Person:

Name:
DR. JORDAN WEAVER
Role:
CHIROPRACTOR
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006006550 2024-12-04
Annual Report 0005540484 2024-01-04
Amendment to Certificate 0005328040 2023-07-20
Change of Registered Office/Agent/Both (by Entity) 0005327981 2023-07-20
Initial Filing 0005059108 2023-01-09

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Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State