Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bloom Center for Pediatric Therapy, LLC

Organization Physical Therapist · NPI 1215397666

Bloom Center for Pediatric Therapy, LLC is a Physical Therapist in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2016.

Licensed in
ID
In the registry since
2016
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7677 W Portneuf Rd
Pocatello, ID 83204-7336
Phone: (208) 604-6260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP-2171 (ID)
Physical Therapist Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1215397666
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Lance — Owner/Speech Language Pathologist · (208) 604-6260
NPI enumeratedFebruary 27, 2016
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026
Mailing address7677 W Portneuf Rd, Pocatello, ID 83204-7336

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