Individual
JAMIE BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 VILLAGE LAKE DR, CHARLOTTE, NC 28212-0081
(704) 536-3663
Mailing address
8711 BOHAM CT, CHARLOTTE, NC 28277-8146
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20718
NC
Other
Enumeration date
01/30/2011
Last updated
01/30/2011
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