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Organization
BLOOM PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization
BLOOM PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA R BLAISDELL DPT (PHYSICAL THERAPIST)
(651) 395-7686
Entity
Organization
Contact information
Practice address
270 72ND ST N, MAHTOMEDI, MN 55115-2079
(651) 497-6997
Mailing address
270 72ND ST N, MAHTOMEDI, MN 55115-2079
(651) 395-7686
(651) 413-2290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/15/2021
Last updated
09/14/2021
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