# BLOSSOM CHIROPRACTIC AND NATURAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902341548
- **Authorized official:** DR. OLIVIA BRESSY CASHMORE D.C., C.C.N (PRESIDENT/OWNER)
- **Authorized official phone:** (262) 220-8500

## Contact information

- **Practice address:** 3601 30TH AVE, SUITE 101, KENOSHA, WI 53144-1695
- **Practice address phone:** (262) 220-8500
- **Mailing address:** 6106 115TH AVE, KENOSHA, WI 53142-7274
- **Mailing address phone:** (262) 220-8500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NN1001X | Nutrition Chiropractor | 038010095 | IL | — |
| 111NN1001X | Nutrition Chiropractor | 5085 | WI | Yes |
| 111NP0017X | Pediatric Chiropractor | 038010095 | IL | — |
| 111NP0017X | Pediatric Chiropractor | 5085 | WI | — |
| 111NR0400X | Rehabilitation Chiropractor | 038010095 | IL | — |
| 111NR0400X | Rehabilitation Chiropractor | 5085 | WI | — |

## Other

- **Enumeration date:** 01/05/2017
- **Last updated:** 01/05/2017