NPI | 1831399393 |
---|---|
Former Name | BREANNA RENEE BLOOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 16192) |
Additional Taxonomies | 171100000X Acupuncturist |
Enumeration Date | 2007-07-23 |
Last Update Date | 2024-03-26 |