| Foundations Pediatric Therapy Pllc | |
|
316 E 1st St, Middleton, ID 83644 | |
| (208) 654-6161 | |
| (208) 473-7320 |
| Full Name | Foundations Pediatric Therapy Pllc |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 316 E 1st St, Middleton, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295339620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XF0002X | Occupational Therapist - Feeding, Eating & Swallowing | (* (Not Available)) | Secondary |
| 225XP0200X | Occupational Therapist - Pediatrics | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Pediatric Therapy Pllc 11536 W Pristinebrook Dr, Star, ID 83669-5784 Ph: (208) 654-6161 | Foundations Pediatric Therapy Pllc 316 E 1st St, Middleton, ID 83644 Ph: (208) 654-6161 |
Mrs. Kathryn Broderius, MOT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 316 E 1st St, Middleton, ID 83644 Phone: 208-654-6161 | |
Tiffany Pollock, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 316 E 1st St, Middleton, ID 83644 Phone: 208-654-6161 Fax: 208-473-7320 |