Organization
HOMEGROWN PEDIATRIC THERAPIES LLC
Active
Parent organization
HOMEGROWN PEDIATRIC THERAPIES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOMEGROWN PEDIATRIC THERAPIES LLC
Authorized official
ROSS GARDNER PT, DPT (OWNER, PHYSICAL THERAPIST)
(208) 613-7361
Entity
Organization
Contact information
Practice address
8000 S 55TH W, IDAHO FALLS, ID 83402-5733
(208) 613-7361
(843) 892-8444
Mailing address
8000 S 55TH W, IDAHO FALLS, ID 83402-5733
(208) 613-7361
(843) 892-8444
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/09/2025
Last updated
06/24/2025
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