Organization
JEANNIE BLOM MD PC
Active
Other names
Jeannie-In-A-Bottle
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNIE M BLOM M.D. (CEO)
(404) 849-3443
Entity
Organization
Contact information
Practice address
2722 N. DECATUR, DECATUR, GA 30033
(404) 849-3443
(404) 467-1004
Mailing address
PO BOX 190218, ATLANTA, GA 31119-0218
(866) 214-8600
(678) 888-0390
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
041517
GA
Other
Enumeration date
10/13/2010
Last updated
12/06/2012
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