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ROCKY MOUNTAIN PHYSICAL THERAPY, PLLC

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Company Details

Name: ROCKY MOUNTAIN PHYSICAL THERAPY, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 Aug 2000 (25 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 52635
Place of Formation: IDAHO
File Number: 52635
ZIP code: 83221
County: Bingham County
Principal Address: 1441 PARKWAY DRIVE BLACKFOOT, ID 83221
Mailing Address: 1441 PARKWAY DR BLACKFOOT, ID 83221-1667

Agent

Name Role Address
BRANDON HAWKER Agent 87 N 825 W, BLACKFOOT, ID 83221

Member

Name Role Address Appointed On
Brandon S Hawker Member 1441 PARKWAY DR, BLACKFOOT, ID 83221 2020-07-03

Unique Entity ID

CAGE Code:
6WQJ3
UEI Expiration Date:
2020-08-06

Business Information

Division Name:
ROCKY MOUNTAIN PHYSICAL THERAPY
Activation Date:
2019-08-07
Initial Registration Date:
2013-05-31

Commercial and government entity program

CAGE number:
6WQJ3
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2022-10-08
CAGE Expiration:
2026-09-14
SAM Expiration:
2022-10-08

Contact Information

POC:
JILLENE C. WARDLE

National Provider Identifier

NPI Number:
1538172648
Certification Date:
2022-12-28

Authorized Person:

Name:
BRANDON SCOTT HAWKER
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
820516495
Plan Year:
2024
Number Of Participants:
0
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005825182 2024-07-20
Annual Report 0005392065 2023-09-08
Annual Report 0004918401 2022-09-17
Annual Report 0004373013 2021-08-07
Annual Report 0003928732 2020-07-03

USAspending Awards / Financial Assistance

Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
43600.00
Total Face Value Of Loan:
43600.00
Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
43600.00
Total Face Value Of Loan:
43600.00

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$43,600
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$43,600
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$44,015.69
Servicing Lender:
Bank of Idaho
Use of Proceeds:
Payroll: $43,600

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Date of last update: 29 Jul 2025

Sources: Idaho Secretary of State