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Individual

DR. PAIGE RENAE BLOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
16860 W WADDELL RD STE 102, SURPRISE, AZ 85388-9621
(602) 643-4054
Mailing address
12448 W HUMMINGBIRD TER, PEORIA, AZ 85383-2213
(641) 780-9925

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002360
AZ

Other

Enumeration date
07/12/2019
Last updated
07/12/2019
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