DON JABLONSKI DO PA
Ambulatory Health at Etowah School Rd, Etowah, NC

License number
North Carolina 9501669
Category
Osteopathic Medicine
Type
Family Medicine
License number
North Carolina 9501669
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: MR. SHANN LYLE DAVIS PA
Title: OWNER
Phone: (828) 890-3200
Address
Address
2 Etowah School Rd, Etowah, NC 28729
National Provider ID: 1588729545
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DON JABLONSKI, D.O., PA

Fountain, NC  -  Whittier, NC  -  Etowah, NC

Status:
Inactive
Industry:
Osteopathic Physician's Office
Doing business as:
Don Jablonski DO
Inactive reason:
Name Change Amendment
Registration:
May 12, 1982
Inactive since:
Aug 14, 2000
Addresses:
2 Etowah School Rd, Fountain, NC 27829 (Physical)
Whittier, NC 28789 (Mailing)
PO Box 2135, Etowah, NC 28729
PO Box 2108, Etowah, NC 28729
2 Etowah School Rd, Etowah, NC 28729
State ID:
F81683
Business type:
Florida Profit Corporation
Entity State:
FL
Treasurer, Director, Secretarys:
Kelly L Davis (Treasurer), PO Box 2108, Whittier, NC 28789 (Physical),Donald Edo Jablonski (Director), PO Box 2108, Etowah, NC 28729 (Physical),Shann L Davis President, Owner, inactive, PO Box 2108, Etowah, NC 28729 (Physical),...
Agent:
Paterniti, Edward,555 W Granada STE C-10, Ormond Beach, FL 32174 (Physical)
EIN:
592192409

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