Individual
MS. CARLA BLOEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
221 W STEWART AVE, SUITE 101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 776-9833
Mailing address
221 W STEWART AVE, SUITE 101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 776-9833
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA160148
OR
Other
Enumeration date
06/27/2006
Last updated
02/12/2015
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