Organization
LARRY M. BLOOM OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLI J SCHULTZ (OFFICE MANAGER)
(419) 882-8467
Entity
Organization
Contact information
Practice address
5600 MONROE ST STE 102, SYLVANIA, OH 43560-2731
(419) 882-8467
(419) 882-8951
Mailing address
5600 MONROE ST, SYLVANIA, OH 43560-2731
(419) 882-8467
(419) 882-8951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2757/T1242
OH
Other
Enumeration date
08/08/2006
Last updated
11/19/2007
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