Individual
DR. BYRON C BLOEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11518 N PORT WASHINGTON RD STE 202, MEQUON, WI 53092-3443
(262) 244-6177
(262) 299-3040
Mailing address
1035 W GLEN OAKS LN, STE. 110, MEQUON, WI 53092-3392
(262) 240-0299
(262) 240-0308
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
057-2140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094192
—
WI
Enumeration date
02/19/2007
Last updated
06/15/2021
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