Individual
AMY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2060 EAST PARIS AVE SE, SUITE 100, GRAND RAPIDS, MI 49546
(616) 956-6100
Mailing address
2060 E PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-6113
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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