Organization
BLOOM SKIN NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI PAULSEN RDN, ATC (PRACTITIONER / OWNER)
(636) 345-2375
Entity
Organization
Contact information
Practice address
14593 WINDWAY DR, GRAND HAVEN, MI 49417-7677
(636) 345-2375
Mailing address
14593 WINDWAY DR, GRAND HAVEN, MI 49417-7677
(636) 345-2375
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
07/07/2017
Last updated
06/24/2025
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