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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ERNEST RANDY BLOOM, PTA

Active Sole Proprietor

ERNEST RANDY BLOOM, PTA is a Occupational Therapist healthcare provider located in AUGUSTA, Georgia. NPI 1366561011 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · AUGUSTA, GA

Registration Details

NPI Number
1366561011
Provider Type
Individual
Gender
Male
NPI Issued
Mar 27, 2007 (19.348716449916 yrs)
Last Updated
Jul 21, 2022
Licenses
TE007060 (PA)
PTA002060 (GA)
Sole Proprietor
Yes

Practice Information

Address
1930 HIGHLAND AVENUE SUITE A
AUGUSTA, GA, 309047803
Browse GA providers · Browse ZIP 30904
Phone
7064819105
Fax
7064819107
Primary Specialty
Occupational Therapist
225200000X
Additional Specialty
Occupational Therapist

Other Occupational Therapist Providers in AUGUSTA, GA

Name Credential NPI
MR. ERIC H. JOHNSON PTA 1982719712
JOHN VINCENT HAMMETT III PTA 1326165242
EARL BRUCE CHAPMAN P.T. 1285752626
SHERRI J. EBETINO PTA 1972621332
MR. RALPH A KENNY 1407080237
LAURA EVELYN BOONE RPTA 1942510888
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.