Individual
MS. FANNIE LIVADITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2920 BRYANT AVE S, SUITE 102, MINNEAPOLIS, MN 55408-2195
(612) 578-5443
Mailing address
1082 KIRKWOOD DR, EAGAN, MN 55123-1911
(612) 578-5443
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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