Individual
DR. MARC WARREN BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8794 EASTON RD, OTTSVILLE, PA 18942-9669
(610) 847-9936
(610) 847-9936
Mailing address
8 HOMESTEAD RD, KINTNERSVILLE, PA 18930-9637
(610) 847-9936
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1079
MT
111NR0400X
Rehabilitation Chiropractor
1079
MT
111NR0400X
Rehabilitation Chiropractor
Primary
DC002902L
PA
111NS0005X
Sports Physician Chiropractor
1079
MT
111NS0005X
Sports Physician Chiropractor
DC002902L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000089742
HIGHMARK BLUE SHIELD ID
PA
01
—
0023261000
BLUE CROSS HMO ID
PA
Enumeration date
03/20/2006
Last updated
07/19/2012
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