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Organization

BLOOM PEDIATRIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE SPILLMAN MS CCC SLP (OWNER)
(270) 646-6393
Entity
Organization

Contact information

Practice address
722 LESLIE AVE, GLASGOW, KY 42141-2115
(270) 646-6393
Mailing address
722 LESLIE AVE, GLASGOW, KY 42141-2115
(270) 646-6393

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
02/02/2021
Last updated
02/09/2021
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