| In Bloom Wellness Pllc | |
|
215 W North 9th St Shelbyville IL 62565-1015 | |
| (765) 404-4002 | |
| (217) 615-1142 |
| Full Name | In Bloom Wellness Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 215 W North 9th St, Shelbyville, Illinois |
| Authorized Official Name and Position | Bradi Gordon (OWNER) |
| Authorized Official Contact | 7654044002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| In Bloom Wellness Pllc 215 W North 9th St Shelbyville IL 62565-1015 Ph: (765) 404-4002 | In Bloom Wellness Pllc 215 W North 9th St Shelbyville IL 62565-1015 Ph: (765) 404-4002 |
| NPI Number | 1730867037 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 07/06/2023 |
| Certification Date | 07/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730867037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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