Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 2711800 | OH |
NPI | 1235322140 |
---|---|
Provider Name | Mrs. Marla Kay Blum |
First Address | Zanesville, OH 43701-6972 |
Second Address | Zanesville, OH 43701-6972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 23/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2711800 | INDEPENT PROVIDER (01) | OH |