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General NPI Number Information
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NPI Number | 1912418252
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Entity Type | Organization
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Legal Business Name | BLOOM NATURAL HEALTH, PLLC
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 95 S MAIN ST FL 2
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2506
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Country | US
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Telephone | 860-310-5559
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Fax | 860-310-5561
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Provider Business Mailing Address
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Address Line | 95 S MAIN ST FL 2
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2506
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Country | US
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Telephone | 860-310-5559
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Fax | 860-310-5561
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHRISTINE ELIZABETH LOUDEN
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Credential | ND
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Telephone | 860-310-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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