Basic Information
| Provider Information | |||||||||
| NPI: | 1144794413 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIVING | ||||||||
| FirstName: | BRYDEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14301 EWING AVE S | ||||||||
| Address2: | |||||||||
| City: | BURNSVILLE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553064885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9527465350 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9220 BASS LAKE RD STE 260 | ||||||||
| Address2: | |||||||||
| City: | NEW HOPE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554283019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635330363 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2019 | ||||||||
| LastUpdateDate: | 10/23/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 105910 | MN | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.