Individual
MS. TINA MARIE BLOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD/LDN
Contact information
Practice address
512 BRICKHAVEN DR, RALEIGH, NC 27606-1492
(704) 607-4924
(704) 469-0879
Mailing address
7035 WALNUT BRANCH LANE, CHARLOTTE, NC 28277-8939
(704) 607-4924
(704) 469-0879
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002206
NC
Other
Enumeration date
11/22/2013
Last updated
04/15/2020
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