Individual
CORBEN BLOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 E MOLEN RD, FERRON, UT 84523-4503
(435) 609-6811
Mailing address
90 E 200 N, LOGAN, UT 84321-4034
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
06/12/2023
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