Individual
KRISTIN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 33RD ST S, FARGO, ND 58103-3413
(701) 235-5511
(701) 235-1985
Mailing address
4262 AUBURN AVE, FARGO, ND 58104-8428
(701) 339-3211
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH5702
ND
Other
Enumeration date
08/10/2014
Last updated
08/10/2014
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