Organization
TRIVIUM HEALTH & NUTRITION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MADISON LYNN BRACKETT RD, LD (REGISTERED DIETITIAN)
(405) 240-9240
Entity
Organization
Contact information
Practice address
309 NW 26TH ST, OKLAHOMA CITY, OK 73103-3005
(405) 240-9240
(405) 296-1933
Mailing address
309 NW 26TH ST, OKLAHOMA CITY, OK 73103-3005
(405) 240-9240
(405) 296-1933
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6228274
AETNA
OK
01
—
8067377
CIGNA
OK
Enumeration date
03/29/2022
Last updated
04/08/2022
Update your record
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