Viverant, LLC

NPI #1659893410 in Champlin, Minnesota

Provider Information

NPI Number: 1659893410
Entity Type: Organization
Organization Name: Viverant, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jul 13, 2017
Last Updated: Jul 13, 2017

Practice Location

Address: 8900 109TH AVE N STE 700
City: Champlin
State: Minnesota
ZIP Code: 55316-3150
Phone: (952) 835-4512

Authorized Official

Name: MICHAEL LANHAM
Title: DIRECTOR
Phone: (952) 835-4512

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X
Physical Therapist	225100000X	Primary

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