Individual
KYLE DEAN CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2665 W 78TH ST, CHANHASSEN, MN 55317-4502
(952) 835-4512
(888) 425-0398
Mailing address
7825 3RD ST N STE 105, OAKDALE, MN 55128-5444
(952) 835-4512
(888) 425-0398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11149
MN
Other
Enumeration date
05/29/2018
Last updated
06/23/2021
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