Provider Demographics
NPI:1427747302
Name:BLOOM PELVIC HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:BLOOM PELVIC HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VOHRA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:857-205-5956
Mailing Address - Street 1:61 CENTRAL SQ STE 4
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3096
Mailing Address - Country:US
Mailing Address - Phone:857-574-9786
Mailing Address - Fax:
Practice Address - Street 1:61 CENTRAL SQ STE 4
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3096
Practice Address - Country:US
Practice Address - Phone:857-574-9786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty