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BACK TO FORM PHYSICAL THERAPY P.C.

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Company Details

Name: BACK TO FORM PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 20 Oct 2015 (10 years ago)
Entity Number: 4837008
ZIP code: 10025
County: New York
Place of Formation: New York
Address: 485 CENTRAL PARK WEST, APT 3F, NEW YORK, NY, United States, 10025
Principal Address: 18 EAST 41ST STREET, SUITE 406, NEW YORK, NY, United States, 10017

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
C/O KYLE WARNER DOS Process Agent 485 CENTRAL PARK WEST, APT 3F, NEW YORK, NY, United States, 10025

Chief Executive Officer

Name Role Address
KYLE WARNER Chief Executive Officer 485 CENTRAL PARK WEST, APT 3F, NEW YORK, NY, United States, 10025

National Provider Identifier

NPI Number:
1407211097
Certification Date:
2021-01-15

Authorized Person:

Name:
KYLE WARNER
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
9175914477

History

Start date End date Type Value
2015-10-20 2019-07-15 Address 314 EAST 30TH STREET, NEW YORK, NY, 10016, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
191003060024 2019-10-03 BIENNIAL STATEMENT 2019-10-01
190715060076 2019-07-15 BIENNIAL STATEMENT 2017-10-01
151020000475 2015-10-20 CERTIFICATE OF INCORPORATION 2015-10-20

USAspending Awards / Financial Assistance

Date:
2021-02-05
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
47590.00
Total Face Value Of Loan:
47590.00
Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
47552.00
Total Face Value Of Loan:
47552.00

Paycheck Protection Program

Jobs Reported:
3
Initial Approval Amount:
$47,590
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$47,590
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$47,952.74
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $47,588
Utilities: $1
Jobs Reported:
3
Initial Approval Amount:
$47,552
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$47,552
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$47,974
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $41,552
Rent: $6,000

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State