Healthcare Provider Details

I. General information

NPI: 1306836879
Provider Name (Legal Business Name): BLOOM & ASSOCIATES THERAPY P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 SW 10TH AVE
TOPEKA KS
66604-1916
US

IV. Provider business mailing address

4035 SW 10TH AVE
TOPEKA KS
66604-1916
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-7700
  • Fax: 785-273-7551
Mailing address:
  • Phone: 785-273-7700
  • Fax: 785-273-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: CAROLYN L BLOOM
Title or Position: OWNER PHYSICAL THERAPIST
Credential: P.T.
Phone: 785-273-7700