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General NPI Number Information
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NPI Number | 1144175266
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Entity Type | Organization
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Legal Business Name | BLOOM HEALTH LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1801 W KNAPP ST STE 5
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City | RICE LAKE
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State | WI
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Zip | 54868-1381
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Country | US
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Telephone | 715-663-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 W KNAPP ST STE 5
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City | RICE LAKE
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State | WI
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Zip | 54868-1381
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Country | US
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Telephone | 715-663-6422
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KATYA ALCARAZ VOELKER
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Credential | MD
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Telephone | 7
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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