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Organization
VIVERANT, LLC
Active
Organization
VIVERANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LANHAM (DIRECTOR)
(952) 835-4512
Entity
Organization
Contact information
Practice address
8900 109TH AVE N STE 700, CHAMPLIN, MN 55316-3150
(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
07/13/2017
Last updated
07/13/2017
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