Provider Demographics
NPI:1659085157
Name:BLATTNER, BRANDI LYNN
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:BLATTNER
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 1:745 COUNTY 102 ROAD SE
Mailing Address - Street 2:
Mailing Address - City:EYOTA
Mailing Address - State:MN
Mailing Address - Zip Code:55934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2048 SUPERIOR DR NW STE 500
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-5029
Practice Address - Country:US
Practice Address - Phone:507-289-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor