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Idaho Family Vision, PLLC

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Company Details

Name: Idaho Family Vision, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 29 Mar 2024 (a year ago)
Financial Date End: 31 Mar 2026
Entity Number: 5663351
Place of Formation: IDAHO
File Number: 929304
ZIP code: 83404
County: Bonneville County
Principal Address: 2405 JAFER CT IDAHO FALLS, ID 83404
Mailing Address: 2405 JAFER CT IDAHO FALLS, ID 83404-5587

Agent

Name Role Address
Jared R Ivie Agent 2405 JAFER CT, IDAHO FALLS, ID 83404

Manager

Name Role Address Appointed On
Jared R Ivie Manager 2405 JAFER CT, IDAHO FALLS, ID 83404 2025-02-17

National Provider Identifier

NPI Number:
1689485070
Certification Date:
2025-02-26

Authorized Person:

Name:
CAMERON KEITH HOUSLEY
Role:
PARTNER/DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
2085290873

Filing

Filing Name Filing Number Filing date
Annual Report 0006111257 2025-02-17
Amendment to Certificate 0006068308 2025-01-13
Initial Filing 0005663351 2024-03-29

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Date of last update: 21 Jun 2025

Sources: Idaho Secretary of State