| NPI | 1174230866 |
|---|---|
| Doing Business As | BLOOM TRADITIONAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JAZMINE M COLLINS President/ Provider 512-893-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2022-11-01 |