Individual
MRS. SUSAN ANN BLOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Mailing address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
547-091
WI
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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