Provider Demographics
NPI:1912688631
Name:YENTER, DANIEL CONRAD
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CONRAD
Last Name:YENTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-4848
Mailing Address - Country:US
Mailing Address - Phone:612-269-9612
Mailing Address - Fax:
Practice Address - Street 1:4551 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-4848
Practice Address - Country:US
Practice Address - Phone:612-269-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist