Individual
DR. L. W. BLOOMINGBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
138 S WASHINGTON AVE, HENDERSON, TN 38340-2323
(731) 989-3511
(731) 989-3515
Mailing address
PO BOX 367, 138 S. WASHINGTON AVENUE, HENDERSON, TN 38340-0367
(731) 989-3511
(731) 989-3515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
573
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359351B
—
TN
Enumeration date
10/24/2006
Last updated
02/26/2008
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