Organization
KALEIDOSCOPE PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATIE ROWE PT, DPT (OWNER)
(208) 375-4200
Entity
Organization
Contact information
Practice address
7211 W FRANKLIN RD, BOISE, ID 83709-0926
(208) 375-4200
(208) 375-4201
Mailing address
7211 W FRANKLIN RD, BOISE, ID 83709-0926
(208) 375-4200
(208) 375-4201
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-1860
ID
225X00000X
Occupational Therapist
Primary
OT-709
ID
235Z00000X
Speech-Language Pathologist
SLP-1992
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083876916
—
ID
05
—
1124199443
—
ID
05
—
1881962538
—
ID
Enumeration date
02/02/2012
Last updated
02/01/2023
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