BLOOM AND GROW PEDIATRICS LLC NPI 1760956031

NPI Information

BLOOM AND GROW PEDIATRICS LLC is a primary care clinic center in Cloudcroft, NM. BLOOM AND GROW PEDIATRICS LLC NPI is 1760956031. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bloom And Grow Pediatrics.

The provider's business location address is:

1315 BURRO AVE
CLOUDCROFT, NM
ZIP 88317-719
Phone: (575) 682-2002

The provider's authorized official is Susan Bruce .
The authorized official title is Owner and has the following contact phone number (575) 921-2318.

The CLIA number assigned to this NPI record is 32D2160058 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2019 and was last updated on 9/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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