Individual
CIERRA BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6645 DEER RD SE, DENNISON, OH 44621-9363
(330) 401-4702
Mailing address
6645 DEER RD SE, DENNISON, OH 44621-9363
(330) 401-4702
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028647
22 (RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)
—
Enumeration date
06/07/2017
Last updated
07/21/2022
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