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Individual

SHELLEY BLOOMQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 NORTH MAIN ST., WYOMING COUNTY COMMUNITY HOSPITAL, WARSAW, NY 14469
(585) 786-2233
(585) 786-1275
Mailing address
6083 BIG TREE RD, LIVONIA, NY 14487-9752
(585) 346-6664

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
003619-1
NY
225700000X
Massage Therapist
022063-1
NY

Other

Enumeration date
01/16/2007
Last updated
01/29/2009
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