Ty Bloom

NPI #1588336952 in Boscobel, Wisconsin

Provider Information

NPI Number: 1588336952
Entity Type: Individual
Name: Ty Bloom
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Oct 4, 2021
Last Updated: Oct 4, 2021

Practice Location

Address: 207 PARKER ST
City: Boscobel
State: Wisconsin
ZIP Code: 53805-1642
Phone: (608) 375-6342

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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