Provider Demographics
NPI:1477723492
Name:KENSINGER, ELISA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:MARIE
Last Name:KENSINGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 E 117TH ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1269
Mailing Address - Country:US
Mailing Address - Phone:952-894-5108
Mailing Address - Fax:952-890-5950
Practice Address - Street 1:2424 E 117TH ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1269
Practice Address - Country:US
Practice Address - Phone:952-894-5108
Practice Address - Fax:952-890-5950
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor