Individual
DOUGLAS VANCE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
NHC KNOXVILLE 809 EMERALD AVE, KNOXVILLE, TN 37917
(865) 524-7366
(865) 637-4402
Mailing address
703 TURTLE CREEK DRIVE, KNOXVILLE, TN 37934
(865) 777-1362
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000002922
TN
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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