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SUNRISE KETAMINE CLINIC, PLLC

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Company Details

Name: SUNRISE KETAMINE CLINIC, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 Jan 2018 (7 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 587935
Place of Formation: IDAHO
File Number: 587935
ZIP code: 83401
County: Bonneville County
Principal Address: 6875 E VALVERDE ST IDAHO FALLS, ID 83401
Mailing Address: TODD MERKLEY 6875 E VAL VERDE ST IDAHO FALLS, ID 83401-5921

Agent

Name Role Address
TODD MERKLEY Agent 6875 E VALVERDE ST, IDAHO FALLS, ID 83401

Manager

Name Role Address Appointed On
TODD MERKLEY Manager 6875 E VALVERDE ST, IDAHO FALLS, ID 83401 2021-02-05

National Provider Identifier

NPI Number:
1205598398
Certification Date:
2021-10-06

Authorized Person:

Name:
BRYAN TODD MERKLEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2085293786

Filing

Filing Name Filing Number Filing date
Annual Report 0006058564 2025-01-09
Annual Report 0005544055 2024-01-05
Annual Report 0005020066 2022-12-08
Annual Report 0004511804 2021-12-03
Annual Report 0004165557 2021-02-05

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State