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Lake Bound Physical Therapy PLLC

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Company Details

Name: Lake Bound Physical Therapy PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 03 Apr 2023 (2 years ago)
Financial Date End: 30 Apr 2025
Entity Number: 5177392
Place of Formation: IDAHO
File Number: 872123
ZIP code: 83815
County: Kootenai County
Principal Address: 3654 W CALZADO DR COEUR D ALENE, ID 83815
Mailing Address: 3654 W CALZADO DR COEUR D ALENE, ID 83815-5091

Agent

Name Role Address
Amelie Golden Agent 3654 W CALZADO DR, COEUR D ALENE, ID 83815

Manager

Name Role Address Appointed On
Amelie Golden Manager 3654 W CALZADO DR, COEUR D ALENE, ID 83815 2024-04-26

National Provider Identifier

NPI Number:
1104511252
Certification Date:
2023-04-05

Authorized Person:

Name:
AMELIE GOLDEN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005704977 2024-04-26
Initial Filing 0005177392 2023-04-03

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Date of last update: 10 Jul 2025

Sources: Idaho Secretary of State