Thea M Blom
Hand
1111 Leffingwell Ave Ne Suite 200
Grand Rapids
, Michigan 49525-6406
(616) 459-7101
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About
Features
Specialties
- Hand
Languages spoken
- English
Location
First Address
- Thea M Blom
- 1111 Leffingwell Ave Ne Suite 200
- Grand Rapids, MI
- Zip : 49525-6406
- Phone : (616) 459-7101
Second Address
- Thea M Blom
- 1111 Leffingwell Ave Ne Suite 200
- Grand Rapids, MI
- Zip : 49525-6406
- Phone : (616) 459-7101
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251H1200X | Hand | 5501002432 | MI |
National Provider Identifier
| NPI | 1619109295 |
|---|---|
| Provider Name | Thea M Blom |
| First Address | Grand Rapids, MI 49525-6406 |
| Second Address | Grand Rapids, MI 49525-6406 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2009 |
| Last Update Date | 09/09/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.