Provider Demographics
NPI:1073801080
Name:PATHWAY TO WELLNESS
Entity Type:Organization
Organization Name:PATHWAY TO WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CM
Authorized Official - Phone:435-586-2049
Mailing Address - Street 1:415 W MIDVALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-7416
Mailing Address - Country:US
Mailing Address - Phone:435-586-2049
Mailing Address - Fax:
Practice Address - Street 1:1800 W ROYAL HUNTE DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-1800
Practice Address - Country:US
Practice Address - Phone:435-586-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing