Provider Demographics
NPI:1407825888
Name:SORRENTINO, ANNE P (DC, DACBSP)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:P
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:DC, DACBSP
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:SORRENTINO
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, DACBSP
Mailing Address - Street 1:8502 TYCO RD STE B
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2276
Mailing Address - Country:US
Mailing Address - Phone:724-840-3443
Mailing Address - Fax:
Practice Address - Street 1:8502 TYCO RD STE B
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2276
Practice Address - Country:US
Practice Address - Phone:724-840-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003779L111NS0005X
VA0104556993111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician