Provider Demographics
NPI:1336862945
Name:AB NATUROPATH LLC
Entity Type:Organization
Organization Name:AB NATUROPATH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR, MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:602-501-5491
Mailing Address - Street 1:201B ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-3403
Mailing Address - Country:US
Mailing Address - Phone:563-208-6636
Mailing Address - Fax:
Practice Address - Street 1:201B ALLEN ST
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-3403
Practice Address - Country:US
Practice Address - Phone:564-208-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty