Individual
LONNA DEE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 395-1130
(970) 353-9906
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
114
CO
Other
Enumeration date
02/16/2009
Last updated
07/10/2009
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