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EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C.

Company Details

Name: EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Voluntarily Dissolved
Date of registration: 21 May 1996 (29 years ago)
Date dissolved: 31 Dec 2022
Entity Number: 19961068964
ZIP code: 80433
County: Jefferson County
Place of Formation: COLORADO
Principal Address: 26719 Pleasant Park Rd Suite 220 Conifer CO 80433 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2017 841345795 2018-07-21 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address 26719 PLEASANT PARK ROAD, SUITE 220, CONIFER, CO, 80433

Signature of

Role Plan administrator
Date 2018-07-21
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2017 841345795 2018-07-19 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 1
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2018-07-19
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2017 841345795 2018-07-21 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address 26719 PLEASANT PARK ROAD, SUITE 220, CONIFER, CO, 80433

Signature of

Role Plan administrator
Date 2018-07-21
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2017 841345795 2018-07-19 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 4
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2018-07-18
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2016 841345795 2017-07-18 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2017-07-18
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2015 841345795 2016-07-11 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2016-07-11
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2014 841345795 2015-06-30 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2015-06-30
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2013 841345795 2014-06-17 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Signature of

Role Plan administrator
Date 2014-06-17
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2012 841345795 2013-05-08 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Plan administrator’s name and address

Administrator’s EIN 841345795
Plan administrator’s name EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C.
Plan administrator’s address 2942 EVERGREEN PKWY, EVERGREEN, CO, 804397909
Administrator’s telephone number 3036704802

Signature of

Role Plan administrator
Date 2013-05-08
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature
EVERGREEN SPORT & SPINE PHYSICAL THERAPY PC 401K PLAN 2011 841345795 2012-07-20 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621340
Sponsor’s telephone number 3036747086
Plan sponsor’s address PO BOX 12552, DENVER, CO, 802120552

Plan administrator’s name and address

Administrator’s EIN 841345795
Plan administrator’s name EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C.
Plan administrator’s address 2942 EVERGREEN PKWY, EVERGREEN, CO, 804397909
Administrator’s telephone number 3036704802

Signature of

Role Plan administrator
Date 2012-07-20
Name of individual signing KIMBERLY KAISER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KIMBERLY S. KAISER Agent 26719 Pleasant Park Rd Suite 220 Conifer CO 80433 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20228217516 Dissolve a Profit Corporation 2022-12-15 2022-12-31 EVERGREEN SPORT & SPINE PHYSICAL THERAPY, P.C., Dissolved December 31, 2022 No data
20221644321 File Report 2022-06-29 2022-06-29 No data No data
20211501232 File Report 2021-05-26 2021-05-26 No data No data
20201371909 File Report 2020-04-24 2020-04-24 No data No data
20191479658 File Report 2019-06-10 2019-06-10 No data No data
20181325029 File Report 2018-04-23 2018-04-23 No data Removed entity mailing address;Removed agent mailing address;
20171364397 File Report 2017-05-11 2017-05-11 No data No data
20161291831 File Report 2016-04-25 2016-04-25 No data No data
20151302765 File Report 2015-05-01 2015-05-01 No data No data
20141279986 File Report 2014-04-30 2014-04-30 No data Change of Entity Address

Date of last update: 17 Feb 2025

Sources: Colorado's Secretary of State