Viverant, LLC
Physical Therapist in Saint Louis Park, MN. Organization (NPI-2).
NPI number1124540968
StatusActive
Last updated in NPPESJun 1, 2020
Details
- NPI
- 1124540968
- Entity type
- Organization (NPI-2)
- Legal business name
- Viverant, LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 13, 2017
- Certification date
- Jun 1, 2020
- Last updated
- Jun 1, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 133V00000X | Dietitian, Registered | – | – |
Practice location
3912 Excelsior BlvdSaint Louis Park, MN 55416-4709
Phone 952-835-4512
Mailing address
7825 3rd St NSte 105
Oakdale, MN 55128-5444
Phone 952-835-4512
Authorized official
Michael Lanham
Director
9528354512
Is something wrong?
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All 14 Physical Therapist providers in Saint Louis Park · All 441 providers in Saint Louis Park
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