Organization
FOUNDATIONS PEDIATRIC THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY POLLOCK OTR/L (OWNER / THERAPIST)
(208) 651-6161
Entity
Organization
Contact information
Practice address
316 E 1ST ST, MIDDLETON, ID 83644
(208) 654-6161
(208) 473-7320
Mailing address
11536 W PRISTINEBROOK DR, STAR, ID 83669-5784
(208) 654-6161
(208) 473-7320
Taxonomy
Speciality
Code
Description
License number
State
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/25/2020
Last updated
04/02/2021
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