Bloom Functional Nutrition

NPI #1346787892 in Richmond Hill, Georgia

Provider Information

NPI Number: 1346787892
Entity Type: Organization
Organization Name: Bloom Functional Nutrition
Primary Specialty: Dietitian, Registered
Enumeration Date: Jan 23, 2017
Last Updated: Jan 30, 2024

Practice Location

Address: 322 TIMBERLAND CIR
City: Richmond Hill
State: Georgia
ZIP Code: 31324-6398
Phone: (717) 634-4227

Authorized Official

Name: MALORIE BLAKE, RD
Title: OWNER
Phone: (717) 634-4227

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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