Individual
MS. CAROL B. BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2214 MAIN STREET, LA CROSSE, WI 54601-3918
(608) 784-6970
(608) 784-6970
Mailing address
2214 MAIN ST, LA CROSSE, WI 54601-3918
(608) 784-6970
(608) 784-6970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1231-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40062700
—
WI
Enumeration date
02/15/2008
Last updated
02/15/2008
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