Individual
JENICA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 BROOKSTONE MEADOWS PLZ, ELKHORN, NE 68022-4401
(402) 289-2696
Mailing address
17360 S ST, OMAHA, NE 68135-2208
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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