Individual
CHELSEA RAE BLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16347 MATEO ST, SAN LEANDRO, CA 94578-3129
(510) 909-2430
Mailing address
16347 MATEO ST, SAN LEANDRO, CA 94578-3129
(510) 909-2430
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000029662
CA
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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