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ATLAS Performance Rehab, PC

Company Details

Name: ATLAS Performance Rehab, PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 03 Jul 2024 (a year ago)
Financial Date End: 31 Jul 2025
Entity Number: 5800020
Place of Formation: IDAHO
File Number: 944539
ZIP code: 83204
County: Power County
Mailing Address: 4133 N GARTON LN POCATELLO, ID 83204-7102

Agent

Name Role Address
Blaire Marie Zikratch-Clayson Agent 2957 HAWKWEED ST, POCATELLO, ID 83204

National Provider Identifier

NPI Number:
1679302335
Certification Date:
2024-07-31

Authorized Person:

Name:
BLAIRE ZIKRATCH-CLAYSON
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2085503256

Filing

Filing Name Filing Number Filing date
Initial Filing 0005800020 2024-07-03

Date of last update: 23 May 2025

Sources: Idaho Secretary of State