Organization
BLOOM PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN PLUMMER (CEO)
(812) 320-8892
Entity
Organization
Contact information
Practice address
1286 S BARNES DR, BLOOMINGTON, IN 47401-8632
(812) 320-8892
Mailing address
PO BOX 5443, BLOOMINGTON, IN 47407-5443
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
IN
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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