Individual
DR. BRUCE DAVID BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
25 LAKE ST, WHITE PLAINS, NY 10603-4032
(919) 949-6009
Mailing address
25 LAKE ST, WHITE PLAINS, NY 10603-4032
(919) 949-6009
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
X003040-1
NY
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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