Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THEA M BLOM, PT
Active Sole ProprietorTHEA M BLOM, PT is a 2251H1200X healthcare provider located in GRAND RAPIDS, Michigan. NPI 1619109295 is currently active in the NPPES registry. Verify at CMS.
2251H1200X · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1619109295
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 17, 2009 (17.017239265459 yrs)
- Last Updated
- Sep 9, 2013
- License
-
5501002432 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1111 LEFFINGWELL AVE NESUITE 200GRAND RAPIDS, MI, 495256406Browse MI providers · Browse ZIP 49525
- Phone
- 6164597101
- Primary Specialty
-
2251H1200X
2251H1200X
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.