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KELLOGG PHYSICAL THERAPY

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Company Details

Name: KELLOGG PHYSICAL THERAPY
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 16 Nov 1998 (27 years ago)
Expiration date: 16 Nov 2003
Date dissolved: 12 Jan 1999
Entity Number: 73754
Place of Formation: IDAHO
File Number: 0000073754
ZIP code: 83837
County: Shoshone County
Mailing Address: 740 MCKINLEY AVE KELLOGG, ID 83837

National Provider Identifier

NPI Number:
1700898376

Authorized Person:

Name:
SCOTT L HALL
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2087833015

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000683443 1999-01-12
Initial Filing 0000073754 1998-11-16

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State