| Kendall Blake Bloomer, DC | |
|
401 Se Osceola St, Stuart, FL 34994-2503 | |
| (772) 247-1077 | |
| Not Available |
| Full Name | Kendall Blake Bloomer |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 401 Se Osceola St, Stuart, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437901774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 14973 (Florida) | Primary |
| Provider Name | Premier Wellness Centers Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1639322712 PECOS PAC ID: 8527122241 Enrollment ID: O20090126000102 |
| Mailing Address | Practice Location Address |
|---|---|
| Kendall Blake Bloomer, DC 401 Se Osceola St, Stuart, FL 34994-2503 Ph: () - | Kendall Blake Bloomer, DC 401 Se Osceola St, Stuart, FL 34994-2503 Ph: (772) 247-1077 |
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