Individual
EVAN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1190 FORTUNE BLVD, SHILOH, IL 62269-7358
(314) 338-1685
Mailing address
1190 FORTUNE BLVD, SHILOH, IL 62269-7358
(314) 338-1685
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3527618
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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