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1538846829
JUSTIN LEE SORENSEN
DACULA, GA
NPI
1538846829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: UT 309718-2402)
Enumeration Date
2023-06-29
Last Update Date
2023-06-29
Business Address
JUSTIN LEE SORENSEN PTA
2463 HAMILTON MILL PKWY
DACULA, GA 30019-4648
Phone number: 770-932-9521
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Mailing Address
JUSTIN LEE SORENSEN PTA
PO BOX 80
LITTLEFIELD, AZ 86432-0080
Phone number: 435-525-6341
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