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FULL POTENTIAL PHYSICAL THERAPY, PLLC

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Company Details

Name: FULL POTENTIAL PHYSICAL THERAPY, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 13 Jan 2017 (8 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 535453
Place of Formation: IDAHO
File Number: 535453
ZIP code: 83501
County: Nez Perce County
Principal Address: 3510 12TH STREET, 200 LEWISTON, ID 83501
Mailing Address: STE A 450 THAIN RD LEWISTON, ID 83501-5300

Agent

Name Role Address
SEKER MEDAVARAPU Agent 1926 BIRCH AVE, LEWISTON, ID 83501

Manager

Name Role Address Appointed On Resigned On
Saker Medavarau Manager 450 THAIN RD, STE A, LEWISTON, ID 83501 2022-04-19 No data
Saker r Medavarapu Manager 1926 BIRCH AVE, LEWISTON, ID 83501 2020-12-04 2022-04-19

National Provider Identifier

NPI Number:
1477093334
Certification Date:
2023-11-29

Authorized Person:

Name:
SAKER RAVEE MEDAVARAPU
Role:
PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2087460873
Fax:
2086212995

Filing

Filing Name Filing Number Filing date
Annual Report 0006000656 2024-12-03
Annual Report 0005518295 2023-12-17
Annual Report 0005008654 2022-12-03
Dissolution/Revocation - Administrative 0004702495 2022-04-19
Application for Reinstatement 0004705065 2022-04-19

USAspending Awards / Financial Assistance

Date:
2020-05-03
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:
16533.00
Total Face Value Of Loan:
16533.00

Paycheck Protection Program

Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
16533
Current Approval Amount:
16533
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
16629.44

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Date of last update: 07 Jun 2025

Sources: Idaho Secretary of State