Provider Demographics
NPI:1548666530
Name:JABLONOWSKI, CHERI L (BS, DC)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:L
Last Name:JABLONOWSKI
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:L
Other - Last Name:ELLIS-JABLONOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2685 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:GRAY SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:63039-1218
Mailing Address - Country:US
Mailing Address - Phone:314-341-1672
Mailing Address - Fax:
Practice Address - Street 1:2685 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:GRAY SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:63039-1218
Practice Address - Country:US
Practice Address - Phone:314-341-1672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor