Organization
HODGES PHYSICAL MEDICINE LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD RAY BLOOM SR. D.C. (OWNER/CHIROPRACTOR/BUSINESS MANAGER)
(904) 223-3330
Entity
Organization
Contact information
Practice address
13947 BEACH BLVD, SUITE 202, JACKSONVILLE, FL 32224-1270
(904) 223-3330
(904) 223-4560
Mailing address
13947 BEACH BLVD, SUITE 202, JACKSONVILLE, FL 32224-1270
(904) 223-3330
(904) 223-4560
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH0001278
FL
111N00000X
Chiropractor
CH8853
FL
111N00000X
Chiropractor
Primary
CH9264
FL
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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