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Individual

LAURA L BLOOMQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M. D.

Contact information

Practice address
1675 COUNTY 6, LA CRESCENT, MN 55947-9720
(608) 790-0758
(608) 787-8911
Mailing address
PO BOX 265, LA CROSSE, WI 54602-0265
(608) 790-0758
(608) 787-8911

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31249
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0049214100
MN
01
118296
UCARE
MN
01
8H906BL
BCBS
MN
Enumeration date
11/16/2005
Last updated
09/21/2010
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