JOHNNIE BLOOM

SOMERVILLE, MA
NPI1659456952
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MA  53794)
Enumeration Date2006-10-26
Last Update Date2007-07-08
Business Address
-- JOHNNIE BLOOM LPN
260 BEACON ST
SOMERVILLE, MA 02143-3534
Phone number: 617-661-5700
Mailing Address
-- JOHNNIE BLOOM LPN
260 BEACON ST
SOMERVILLE, MA 02143-3534
Phone number: 617-661-5700