Provider Demographics
NPI:1386013779
Name:BLUM, AUBREE R
Entity Type:Individual
Prefix:MS
First Name:AUBREE
Middle Name:R
Last Name:BLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 W COLD SPRING RD
Mailing Address - Street 2:GREENFIELD REHABILITATION AGENCY
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2814
Mailing Address - Country:US
Mailing Address - Phone:414-327-6603
Mailing Address - Fax:414-327-5411
Practice Address - Street 1:7517 W COLD SPRING RD
Practice Address - Street 2:GREENFIELD REHABILITATION AGENCY
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-2814
Practice Address - Country:US
Practice Address - Phone:414-327-6603
Practice Address - Fax:414-327-5411
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist