Organization
PARENT RESOURCES LLC
Active
Other names
High Performance Sports Nutrition Program
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH KELLY (OWNER / DIRECTOR)
(612) 990-8151
Entity
Organization
Contact information
Practice address
10112 STEVENS AVE S, BLOOMINGTON, MN 55420-4934
(612) 990-8151
Mailing address
10112 STEVENS AVE S, BLOOMINGTON, MN 55420-4934
(612) 990-8151
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
09/08/2017
Last updated
03/29/2026
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