Provider Demographics
NPI:1386048627
Name:DENERY, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DENERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-1118
Mailing Address - Country:US
Mailing Address - Phone:320-732-4357
Mailing Address - Fax:
Practice Address - Street 1:18 2ND ST N
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-1118
Practice Address - Country:US
Practice Address - Phone:320-732-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor