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PRO MOTION THERAPY OF LAKE CITY, LLC - Florida Company Profile

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Company Details

Entity Name: PRO MOTION THERAPY OF LAKE CITY, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 06 Mar 2020 (5 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 01 Nov 2022 (3 years ago)
Document Number: M20000002667
FEI/EIN Number 90-0336865
Mail Address: 1751 Mound Street, Suite 102, Sarasota, FL, 34236, US
Address: 945 SW Main Boulevard, Lake City, FL, 32025, US
ZIP code: 32025
City: Lake City
County: Columbia
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
Zettergren Craig Manager 1751 Mound Street, Sarasota, FL, 34236
Douglass Rick Manager 1751 Mound Street, Sarasota, FL, 34236
- Agent -

National Provider Identifier

NPI Number:
1073801262
Certification Date:
2025-07-02

Authorized Person:

Name:
ERIC ELDON DOUGLASS
Role:
CHIEF CLINICAL OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
7028185001
Fax:
3867553165

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000070602 FYZICAL THERAPY & BALANCE CENTERS ACTIVE 2022-06-09 2027-12-31 - 1751 MOUND STREET, SUITE 102, SARASOTA, FL, 34236

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-29 945 SW Main Boulevard, Lake City, FL 32025 -
CHANGE OF MAILING ADDRESS 2024-03-29 945 SW Main Boulevard, Lake City, FL 32025 -
LC STMNT OF RA/RO CHG 2022-11-01 - -
REGISTERED AGENT NAME CHANGED 2022-11-01 C T CORPORATION SYSTEM -
REGISTERED AGENT ADDRESS CHANGED 2022-11-01 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 -

Documents

Name Date
ANNUAL REPORT 2024-03-29
ANNUAL REPORT 2023-03-03
CORLCRACHG 2022-11-01
ANNUAL REPORT 2022-04-06
AMENDED ANNUAL REPORT 2021-10-20
ANNUAL REPORT 2021-04-29
Foreign Limited 2020-03-06

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Date of last update: 03 Aug 2025

Sources: Florida Department of State