| Name: | Mountain State Breast and General Surgery, PLLC |
| Jurisdiction: | Idaho |
| Legal type: | Limited Liability Company (D) |
| Status: | Active-Existing |
| Date of registration: | 12 Feb 2023 (2 years ago) |
| Financial Date End: | 28 Feb 2025 |
| Entity Number: | 5113220 |
| Place of Formation: | IDAHO |
| File Number: | 863519 |
| ZIP code: | 83705 |
| County: | Ada County |
| Principal Address: | DR. MENEN 1525 S. OWYHEE STREET BOISE, ID 83705 |
| Mailing Address: | DR. MENEN 1525 S OWYHEE ST BOISE, ID 83705-6014 |
| Name | Role | Address |
|---|---|---|
| Ryan Shackelford | Agent | 1525 S OWYHEE STREET, BOISE, ID 83705 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Ryan Shackelford | Member | 1525 S. OWYHEE STREET, BOISE, ID 83705 | 2024-03-04 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Rhiana Menen | Manager | 1525 S. OWYHEE STREET, BOISE, ID 83705 | 2024-03-04 |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0005629792 | 2024-03-04 |
| Initial Filing | 0005113220 | 2023-02-12 |
Date of last update: 07 Jan 2025
Sources: Idaho Secretary of State
