Organization
BLOSSOM CHIROPRACTIC AND NATURAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIVIA BRESSY CASHMORE D.C., C.C.N (PRESIDENT/OWNER)
(262) 220-8500
Entity
Organization
Contact information
Practice address
3601 30TH AVE, SUITE 101, KENOSHA, WI 53144-1695
(262) 220-8500
Mailing address
6106 115TH AVE, KENOSHA, WI 53142-7274
(262) 220-8500
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
038010095
IL
111NN1001X
Nutrition Chiropractor
Primary
5085
WI
111NP0017X
Pediatric Chiropractor
038010095
IL
111NP0017X
Pediatric Chiropractor
5085
WI
111NR0400X
Rehabilitation Chiropractor
038010095
IL
111NR0400X
Rehabilitation Chiropractor
5085
WI
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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