Individual
NICOLE G BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 CENTURY DR STE 130, GREENVILLE, SC 29607-1571
(864) 250-1601
(864) 250-1603
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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