Provider Demographics
NPI:1215250857
Name:ZGONENA, CHERYL (CMT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ZGONENA
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5715
Mailing Address - Country:US
Mailing Address - Phone:303-810-0043
Mailing Address - Fax:
Practice Address - Street 1:695 S COLORADO BLVD STE 265
Practice Address - Street 2:SYNERGY
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8012
Practice Address - Country:US
Practice Address - Phone:303-759-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9666225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist