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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
3912 EXCELSIOR BLVD, SAINT LOUIS PARK, MN 55416-4709
(952) 835-4512
Mailing address
7825 3RD ST N, STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/13/2017
Last updated
06/01/2020
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