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General NPI Number Information
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NPI Number | 1235498395
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Entity Type | Individual
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Provider Name | JAMIE JABLONSKI L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 8120 PENN AVE S SUITE 158
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1358
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Country | US
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Telephone | 952-955-8483
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Fax | 952-955-8487
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Provider Business Mailing Address
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Address Line | 2417 PLEASANT AVE APT 2
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3215
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Country | US
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Telephone | 773-905-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1590
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License Number State | MN
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