Individual
MR. JAMES BLOOMCAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
600 N GRAND AVE, TAHLEQUAH, OK 74464-2301
(918) 444-3921
Mailing address
1103 CHASE AVE, TAHLEQUAH, OK 74464-5294
(918) 931-2948
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT339
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
22
OK
Enumeration date
10/22/2014
Last updated
10/22/2014
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