Andre Blom, PT

NPI #1558317438 in Morton Grove, Illinois

Provider Information

NPI Number: 1558317438
Entity Type: Individual
Name: Andre Blom, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: May 25, 2006
Last Updated: Feb 1, 2013

Practice Location

Address: 9000 WAUKEGAN RD
Address 2: SUITE 100
City: Morton Grove
State: Illinois
ZIP Code: 60053-2111
Phone: (847) 779-6050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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