Organization
SCOTT BLOOM OD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BLOOM O.D. (OWNER)
(269) 945-2192
Entity
Organization
Contact information
Practice address
1510 N BROADWAY ST, HASTINGS, MI 49058-1007
(269) 945-2192
Mailing address
1510 N BROADWAY ST, HASTINGS, MI 49058-1007
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003603
MI
Other
Enumeration date
10/17/2007
Last updated
03/10/2009
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