Individual
EDWARD PATRICK BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
28910 PLYMOUTH RD, LIVONIA, MI 48150-2337
(734) 425-4814
Mailing address
43624 APPOMATTOX CT, CANTON, MI 48188-1707
(734) 634-1273
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008088
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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