Provider Demographics
NPI:1508479486
Name:BLOOM ACUPUNCTURE & INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:BLOOM ACUPUNCTURE & INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPL OM
Authorized Official - Phone:970-235-1473
Mailing Address - Street 1:3320 W EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-9176
Mailing Address - Country:US
Mailing Address - Phone:970-235-1473
Mailing Address - Fax:
Practice Address - Street 1:3320 W EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-9176
Practice Address - Country:US
Practice Address - Phone:970-235-1473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty