Provider Demographics
NPI:1467423731
Name:BLOHM, ROBERT R (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:BLOHM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4436
Mailing Address - Country:US
Mailing Address - Phone:563-242-9122
Mailing Address - Fax:
Practice Address - Street 1:326 3RD AVE S
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4436
Practice Address - Country:US
Practice Address - Phone:563-242-9122
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2005306Medicaid
IA2005306Medicaid
I4600Medicare ID - Type Unspecified