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Organization
VIVERANTOS, LLC
Active
Organization
VIVERANTOS, LLC
Active
Other names
ViverantOS
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RYAN LANHAM (DIRECTOR)
(952) 835-4512
Entity
Organization
Contact information
Practice address
1769 LEXINGTON AVE N, 286, ROSEVILLE, MN 55113-6522
(218) 624-2794
Mailing address
1029 W CENTRAL ENTRANCE, DULUTH, MN 55811-5477
(218) 624-2794
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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