| Doctor Name: | JENNIFER BLOOM |
| NPI Number: | 1497032312 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, PT |
| License Number: | L5151 |
| Business Practice Address: | 1145 Frontier Dr Longmont, CO - 805013108 |
| Business Phone Number: | 3037741781 |
| Business Fax Number: | |
| Mailing Address: | Po Box 471, MEAD |
| State: | CO |
| Postal Code: | 805420471 |
| Phone Number: | 3038700441 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2011 |
| NPI Last Update Date: | 11/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | L5151 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |