Provider Demographics
NPI:1134709371
Name:JOBLONSKI, CAMILLE ANNE
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ANNE
Last Name:JOBLONSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 CORUNNA AVE
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-3913
Mailing Address - Country:US
Mailing Address - Phone:517-974-9517
Mailing Address - Fax:
Practice Address - Street 1:1951 CORUNNA AVE
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-3913
Practice Address - Country:US
Practice Address - Phone:517-974-9517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist