Individual
AMY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1734 PROSPECT DR, PALMER, AK 99645-9655
(252) 635-1788
Mailing address
1734 PROSPECT DR, PALMER, AK 99645-9655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
120733
AK
225100000X
Physical Therapist
16655
NC
Other
Enumeration date
10/11/2016
Last updated
07/20/2022
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