MEDICARE: MRS. BETHANY JOY MOTLEY RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	4454	MN

General Provider Information

NPI Number	:	1255083671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETHANY JOY MOTLEY RD

Provider Business Mailing Address
First Line	:	5625 VINE HILL RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5038
Country	:	US
Telephone Number	:	218-213-6472
Fax Number	:

Provider Business Practice Location Address
First Line	:	5625 VINE HILL RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5038
Country	:	US
Telephone Number	:	218-213-6472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	01/26/2022

Similar Medicare Providers

1407598634 — BETHANYRD NUTRITION LLC
Practice Location Address:

5625 VINE HILL RD
MINNETONKA, MN
55345-5038

Practice Phone: 218-213-6472
Practice Fax:

1780524637 — WILDFLOWER WELLNESS COUNSELING
Practice Location Address:

5125 CTY RD 101 , SUITE 249
MINNETONKA, MN
55345

Practice Phone: 612-249-0069
Practice Fax:

1467773135 — MRS. ANGELA DIANE KLEINEDLER MA CCC-SLP
Practice Location Address:

5621 COUNTY ROAD 101
MINNETONKA, MN
55345-4214

Practice Phone: 952-401-6808
Practice Fax: 952-401-4022

1962085829 — ALEC GREEN ALMQUIST ATC, LAT
Practice Location Address:

14900 MINNETONKA INDUSTRIAL RD
MINNETONKA, MN
55345-2107

Practice Phone: 612-297-9769
Practice Fax:

1659147262 — RACHEL LITCHY LICSW
Practice Location Address:

5125 COUNTY ROAD 101 STE 300
MINNETONKA, MN
55345-4157

Practice Phone: 952-932-7277
Practice Fax: 952-932-9827

1619553559 — NICHOLE MARIE BRUA LPCC
Practice Location Address:

5125 COUNTY ROAD 101 STE 300
MINNETONKA, MN
55345-4157

Practice Phone: 952-932-7277
Practice Fax: 952-932-9827

Directions to “ MRS. BETHANY JOY MOTLEY RD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.