Kelli Ann Vivatson LRD

NPI 1740409044 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1740409044
Gender Female
Enumeration Date 04/25/2007
Last Updated 07/19/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1200 S COLUMBIA RD
GRAND FORKS ND, 58201-4036, US
Phone (701) 780-5000
Fax (701) 780-1942
Business Location
PO BOX 6002
GRAND FORKS ND, 58206-6002, US
Phone (701) 780-5000
Fax (701) 780-1942
Toxanomy
Taxonomy Code 133V00000X
License State North Dakota
License Number 700
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According to our database, Kelli Ann Vivatson LRD NPI is 1740409044, taxonomy code is 133V00000X and license number is 700, license state is located at North Dakota. Kelli Ann Vivatson LRD physically located at 1200 S Columbia Rd, Grand Forks ND, 58201-4036. NPI Number Kelli Ann Vivatson LRD has the Individual type.

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1740409044 NPI number is provided on an as is basis without warranty of any kind. 1740409044 is maintained by the National Plan & Provider Enumeration System. The contents of Kelli Ann Vivatson LRD are for informational purposes only.