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Organization

BLOOM PEDIATRIC THERAPY SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOCELYN JOHNSON (PRESIDENT)
(870) 919-3141
Entity
Organization

Contact information

Practice address
1007 WINDOVER RD STE A, JONESBORO, AR 72401-6009
(870) 520-0646
(870) 520-5034
Mailing address
1007 WINDOVER RD STE A, JONESBORO, AR 72401-6009
(870) 520-0646
(870) 520-5034

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
225X00000X
Occupational Therapist
Primary
OTR1436
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163120742
AR
Enumeration date
03/19/2007
Last updated
03/11/2026
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