Individual
MATT BLANSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRS
Contact information
Practice address
1826 COMMERCE DR, NORTH MANKATO, MN 56003-1800
(507) 229-0350
(507) 216-0371
Mailing address
1826 COMMERCE DR, NORTH MANKATO, MN 56003-1800
(507) 229-0350
(507) 216-0371
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
9613
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9613
CPRS CERTIFICATION
—
Enumeration date
03/11/2024
Last updated
03/11/2024
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