Kendall Blake Bloomer, DC | |
401 Se Osceola St, Stuart, FL 34994-2503 | |
(772) 247-1077 | |
Not Available |
Full Name | Kendall Blake Bloomer |
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Gender | Male |
Speciality | Chiropractor |
Location | 401 Se Osceola St, Stuart, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437901774 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 14973 (Florida) | Primary |
Provider Name | Premier Wellness Centers Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1639322712 PECOS PAC ID: 8527122241 Enrollment ID: O20090126000102 |
Mailing Address | Practice Location Address |
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Kendall Blake Bloomer, DC 401 Se Osceola St, Stuart, FL 34994-2503 Ph: () - | Kendall Blake Bloomer, DC 401 Se Osceola St, Stuart, FL 34994-2503 Ph: (772) 247-1077 |
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