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Organization
VIVERANT PT LLC
Active
Organization
VIVERANT PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS CERNOHOUS (CEO/PARTNER)
(952) 835-4512
Entity
Organization
Contact information
Practice address
3912 EXCELSIOR BLVD, ST.LOUIS PARK, MN 55416-0515
(952) 835-4512
(952) 515-5655
Mailing address
7825 3RD ST N, STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
(952) 516-5655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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