Healthcare Provider Details

I. General information

NPI: 1720010887
Provider Name (Legal Business Name): SEN KHIEV D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 NW 43RD ST STE 11
GAINESVILLE FL
32606-4460
US

IV. Provider business mailing address

4915 NW 43RD ST STE 11
GAINESVILLE FL
32606-4460
US

V. Phone/Fax

Practice location:
  • Phone: 352-363-1985
  • Fax:
Mailing address:
  • Phone: 352-363-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: