Individual
ELLEN B BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 BLYMYER AVE, MANSFIELD, OH 44903-2343
(419) 774-5100
Mailing address
8751 WHIPPOORWILL RD, DIAMOND, OH 44412-9708
(330) 414-0382
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3727
OH
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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