Organization
JEANNIE-IN-A-BOTTLE LLC
Active
Other names
Jeannie Blom
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNIE M BLOM M.D. (CEO)
(404) 849-3443
Entity
Organization
Contact information
Practice address
3620 HOWELL FERRY RD, DULUTH, GA 30096-3178
(678) 312-6800
(678) 312-5622
Mailing address
1343 CANTON RD STE C, MARIETTA, GA 30066-6079
(866) 214-8600
(678) 888-0390
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
041517
GA
Other
Enumeration date
08/05/2008
Last updated
05/22/2013
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