Individual
MS. TRACI RAE BLOEDORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARCB
Contact information
Practice address
N8380 OLD HIGHWAY 47, BLACK CREEK, WI 54106-9152
(920) 525-3011
Mailing address
N8380 OLD HIGHWAY 47, BLACK CREEK, WI 54106-9152
(920) 525-3011
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
BO1207
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BO1207
ARCB NATIONAL CERTIFICATION NUMBER BO1207
WI
Enumeration date
08/20/2009
Last updated
08/20/2009
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