# HOMEGROWN PEDIATRIC THERAPIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HomeGrown PT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043910441
- **Authorized official:** ROSS GARDNER PT, DPT (OWNER, PHYSICAL THERAPIST)
- **Authorized official phone:** (208) 613-7361

## Contact information

- **Practice address:** 201 SIGMA DRIVE, SUITE 300, SUMMERVILLE, SC 29486-7722
- **Practice address phone:** (208) 613-7361
- **Practice address fax:** (843) 892-8444
- **Mailing address:** 201 SIGMA DRIVE, SUITE 300, SUMMERVILLE, SC 29486-7722
- **Mailing address phone:** (208) 613-7361
- **Mailing address fax:** (843) 892-8444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | — |
| 2251P0200X | Pediatric Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 2355S0801X | Speech-Language Assistant | — | NULL | — |
| 2355S0801X | Speech-Language Assistant | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 03/06/2023
- **Last updated:** 07/01/2025