Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 3993-024 | WI |
NPI | 1275728040 |
---|---|
Provider Name | Paula Sorensen |
First Address | Neenah, WI 54956-4968 |
Second Address | Neenah, WI 54956-2883 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 13/09/2007 |