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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
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