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1619109295
THEA M BLOM
GRAND RAPIDS, MI
NPI
1619109295
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2251H1200X Physical Therapist Hand
(Licence: MI 5501002432)
Enumeration Date
2009-08-17
Last Update Date
2013-09-09
Business Address
THEA M BLOM PT
1111 LEFFINGWELL AVE NE SUITE 200
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
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Mailing Address
THEA M BLOM PT
1111 LEFFINGWELL AVE NE SUITE 200
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
Copy
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