Organization
BLOOM PHYSICAL THERAPY, LLC
Active
Organization
BLOOM PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BLOOM (OWNER)
(808) 224-5802
Entity
Organization
Contact information
Practice address
3035 S ELLSWORTH RD STE 128, MESA, AZ 85212-2161
(480) 357-6500
Mailing address
3035 S ELLSWORTH RD STE 128, MESA, AZ 85212-2161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8969
AZ
Other
Enumeration date
11/19/2016
Last updated
11/19/2016
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