Search icon

Mountain West Spine, LLC

Company claim

Is this your business?

Get access!

Company Details

Name: Mountain West Spine, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 11 Mar 2024 (a year ago)
Financial Date End: 31 Mar 2026
Entity Number: 5644211
Place of Formation: IDAHO
File Number: 926000
ZIP code: 83642
County: Ada County
Principal Address: SUITE 200 2960 E. ST. LUKES STREET MERIDIAN, ID 83642
Mailing Address: 1545 N PROMONTORY RD BOISE, ID 83702-3043

Agent

Name Role Address
William D Bradley Agent 2960 E ST LUKES STREET, SUITE 200, MERIDIAN, ID 83642

Manager

Name Role Address Appointed On
William D Bradley Manager 1545 N PROMONTORY RD, BOISE, ID 83702 2025-04-14

National Provider Identifier

NPI Number:
1982462008
Certification Date:
2024-07-08

Authorized Person:

Name:
WILLIAM BRADLEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
207XS0117X - Orthopaedic Surgery of the Spine Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006206398 2025-04-14
Initial Filing 0005644211 2024-03-11

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 21 Jun 2025

Sources: Idaho Secretary of State