Larry M. Bloom Od
Optometrist in Sylvania, OH. Organization (NPI-2).
NPI number1952310773
StatusActive
Last updated in NPPESNov 19, 2007
Details
- NPI
- 1952310773
- Entity type
- Organization (NPI-2)
- Legal business name
- Larry M. Bloom Od
- Organization subpart
- No
- Enumeration date
- Aug 8, 2006
- Last updated
- Nov 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2757/T1242 | OH | Yes |
Practice location
5600 Monroe St Ste 102Sylvania, OH 43560-2731
Phone 419-882-8467 · Fax 419-882-8951
Mailing address
5600 Monroe StSylvania, OH 43560-2731
Phone 419-882-8467 · Fax 419-882-8951
Authorized official
Kelli J Schultz
Office Manager
4198828467
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