Healthcare Provider Details

I. General information

NPI: 1225179971
Provider Name (Legal Business Name): DENNIS JOHN LENSELINK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 AMERICAN BLVD W SUITE 945
BLOOMINGTON MN
55437-1162
US

IV. Provider business mailing address

5001 AMERICAN BLVD W SUITE 945
BLOOMINGTON MN
55437-1162
US

V. Phone/Fax

Practice location:
  • Phone: 952-835-6653
  • Fax: 952-835-3895
Mailing address:
  • Phone: 952-835-6653
  • Fax: 952-835-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1815
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number401
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: