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EAST IDAHO EAR NOSE THROAT-FACIAL PLASTIC SURGERY, P.A.

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Company Details

Name: EAST IDAHO EAR NOSE THROAT-FACIAL PLASTIC SURGERY, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 02 Oct 2009 (16 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 558207
Place of Formation: IDAHO
File Number: 558207
ZIP code: 83404
County: Bonneville County
Mailing Address: 3446 S 15TH E IDAHO FALLS, ID 83404-8262

Agent

Name Role Address
Richard G Lee Agent 518 N 4000 E, RIGBY, ID 83442

President

Name Role Address Appointed On
Richard G Lee President 518 N 4000 EAST, RIGBY, ID 83442 2020-11-05

Secretary

Name Role Address Appointed On Resigned On
Heidi Lee Secretary 518 N 4000 EAST, RIGBY, ID 83442 2023-09-03 2023-09-03

National Provider Identifier

NPI Number:
1275808750
Certification Date:
2024-04-04

Authorized Person:

Name:
DR. RICHARD GARRETT LEE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207YP0228X - Pediatric Otolaryngology Physician
Is Primary:
Yes

Contacts:

Fax:
2085220550

Filing

Filing Name Filing Number Filing date
Annual Report 0005975838 2024-11-09
Annual Report 0005379060 2023-09-03
Annual Report 0004975034 2022-11-04
Annual Report 0004523104 2021-12-09
Annual Report 0004059729 2020-11-05

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$77,100
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$77,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$77,799.53
Servicing Lender:
Bank of Idaho
Use of Proceeds:
Payroll: $77,000

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State