Individual
ERICA BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29230 STATE ROUTE 58, SULLIVAN, OH 44880-9603
(440) 935-7084
Mailing address
29230 STATE ROUTE 58, SULLIVAN, OH 44880-9603
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
154617
OH
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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