BLOOM CENTER FOR PEDIATRIC THERAPY

POCATELLO, ID
NPI1215397666
Entity TypeOrganization
Authorized ContactMICHELLE LEE LANCE
Owner/Speech Language Pathologist
208-604-6260
Organization Subpart ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: ID  SLP-2171)
Enumeration Date2016-02-27
Last Update Date2016-04-04
Business Address
BLOOM CENTER FOR PEDIATRIC THERAPY
7677 W PORTNEUF RD
POCATELLO, ID 83204-7336
Phone number: 208-604-6260
Mailing Address
BLOOM CENTER FOR PEDIATRIC THERAPY
7677 W PORTNEUF RD
POCATELLO, ID 83204-7336
Phone number: 208-604-6260