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ELLISON FAMILY CHIROPRACTIC

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Company Details

Name: ELLISON FAMILY CHIROPRACTIC
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 07 Aug 1998 (27 years ago)
Entity Number: 65770
Place of Formation: IDAHO
File Number: 0000065770
ZIP code: 83642
County: Ada County
Mailing Address: 1560 N CRESTMONT STE G MERIDIAN, ID 83642

National Provider Identifier

NPI Number:
1508188400

Authorized Person:

Name:
DR. GARY CRAIG ELLISON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
2088848802

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000677105 2010-02-26
Initial Filing 0000065770 1998-08-07

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State