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Organization
VIVERANT, LLC
Active
Organization
VIVERANT, LLC
Active
Parent organization
VIVERANT PT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VIVERANT PT LLC
Authorized official
MICHAEL LANHAM (DIRECTOR)
(952) 835-4512
Entity
Organization
Contact information
Practice address
5400 FRANCE AVE S, EDINA, MN 55410-2356
(952) 835-4512
Mailing address
1769 LEXINGTON AVE N # 286, ROSEVILLE, MN 55113-6522
(952) 835-4512
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/28/2017
Last updated
06/01/2020
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