Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC002091L | PA |
N | 111NR0400X | Rehabilitation Chiropractor | DC002901L | PA |
N | 111NS0005X | Chiropractic Sports Physician | DC002901L | PA |
NPI | 1144273319 |
---|---|
Provider Name | Mr. Howard Aaron Bloom |
First Address | Churchville, PA 18966-1508 |
Second Address | Churchville, PA 18966-1508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 10/03/2011 |