Search icon

LIBERTY LAKE FAMILY & SPORTS MEDICINE, P.S.

Company claim

Is this your business?

Get access!

Company Details

Legal Name: LIBERTY LAKE FAMILY & SPORTS MEDICINE, P.S.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: November 5th 1999
Date of Dissolution: March 1st 2013
Expiration date: 30 Nov 2012
UBI Number: 601 991 291

Reviews Leave a review

Be the first to leave a review!

Registered Agent Information

Name Role Address
TIMOTHY P MANSON MD Registered Agent 2207 N MOLTER RD STE 101, LIBERTY LAKE, WA, 99019-7571, UNITED STATES

Key Officers & Management

Name Role Address
TIMOTHY MANSON Governing Person 2207 N MOLTER RD, STE 101A, LIBERTY LAKE, WA, 99019, UNITED STATES

National Provider Identifier

NPI Number:
1043407935

Authorized Person:

Name:
TIMOTHY MANSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207QS0010X - Sports Medicine (Family Medicine) Physician
Is Primary:
Yes

Contacts:

See something incorrect or outdated? Let us know