Individual
DENVER CHENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3222 BIRCH PL, MINNETONKA, MN 55305-4511
(612) 207-1497
Mailing address
3222 BIRCH PL, MINNETONKA, MN 55305-4511
(612) 207-1497
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001058197
SUPPLIER NUMBER
MN
Enumeration date
07/10/2020
Last updated
07/10/2020
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