Healthcare Provider Details

I. General information

NPI: 1578042206
Provider Name (Legal Business Name): SENYI LY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 RICE ST STE 155
ROSEVILLE MN
55113-3720
US

IV. Provider business mailing address

2345 RICE ST STE 155
ROSEVILLE MN
55113-3720
US

V. Phone/Fax

Practice location:
  • Phone: 651-528-7978
  • Fax: 651-528-7941
Mailing address:
  • Phone: 651-528-7978
  • Fax: 651-528-7941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6527
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number6527
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: