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REVITA REHAB NORTH LLC

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Company Details

Legal Name: REVITA REHAB NORTH LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: March 27th 2012
Date of Dissolution: July 1st 2014
Expiration date: 31 Mar 2014
UBI Number: 603 193 669
ZIP code: 99208
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 203 EAST DALKE, SPOKANE, WA, 99208, UNITED STATES

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Registered Agent Information

Name Role Address
ALAN RUBENS Registered Agent 720 W BOONE SUITE 200, SPOKANE, WA, 99201, UNITED STATES

Key Officers & Management

Name Role
JAMIE PETERSON Governing Person
REVITA CLINICS LLC Governing Person
BARBARA MOE Governing Person
CRAIG PETERSON Governing Person

National Provider Identifier

NPI Number:
1457618902

Authorized Person:

Name:
BETH ELMORE
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
5094838338
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