NPI 1376213934 · live from the CMS NPI Registry
Bradley Management LLC
Dietitian, Registered in Edina, MN. National Provider Identifier 1376213934, active.
NPI record
| NPI | 1376213934 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 3250 W 66th St, Edina, MN 55435 |
| Practice phone | 320-309-8913 |
| Mailing address | 2713 W 54th St, Minneapolis, MN 55410 |
| Enumerated | September 15, 2021 |
| Last updated | March 6, 2024 |
| Authorized official | Emma Backes, Registered Dietitian |
| Other names | Dietitian Live |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.