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General NPI Number Information
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NPI Number | 1699679316
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Entity Type | Organization
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Legal Business Name | BLOOM INSTITUTE OF PELVIC THERAPY
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 12 E ROWAN AVE STE L2
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City | SPOKANE
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State | WA
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Zip | 99207-1281
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Country | US
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Telephone | 208-819-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 17208 HAMILTON LN
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City | COLBERT
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State | WA
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Zip | 99005-5105
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Country | US
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Telephone | 208-819-7837
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MCKENNA YOUNG
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Credential | PT
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Telephone | 208-819-7837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | NULL
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