Provider Demographics
NPI:1144273319
Name:BLOOM, HOWARD AARON (DC, CCEP)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:AARON
Last Name:BLOOM
Suffix:
Gender:M
Credentials:DC, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1508
Mailing Address - Country:US
Mailing Address - Phone:215-322-1300
Mailing Address - Fax:215-322-5301
Practice Address - Street 1:120 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:PA
Practice Address - Zip Code:18966-1508
Practice Address - Country:US
Practice Address - Phone:215-322-1300
Practice Address - Fax:215-322-5301
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002091L111N00000X
PADC002901L111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician