Organization · NPI-2

Bloom Hormone Health

Clinic/Center · Fort Wayne, IN

NPI number1922812890
StatusActive
Last updated in NPPESFeb 3, 2025

Details

NPI
1922812890
Entity type
Organization (NPI-2)
Legal business name
Bloom Hormone Health
Organization subpart
No
Enumeration date
Feb 3, 2025
Certification date
Feb 3, 2025
Last updated
Feb 3, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

10339 Dawsons Creek Blvd
Fort Wayne, IN 46825-1907

Phone 260-999-7147

Mailing address

10339 Dawsons Creek Blvd
Fort Wayne, IN 46825-1907

Phone 260-999-7147

Authorized official

Leigh Bauer
Owner
2609997147

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