Provider Demographics
NPI:1477503548
Name:WILLIAM PICKENS SORRELS JR
Entity Type:Organization
Organization Name:WILLIAM PICKENS SORRELS JR
Other - Org Name:THERAPY WORKS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P,
Authorized Official - Last Name:SORRELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-778-3898
Mailing Address - Street 1:1913 N BERKELEY BLVD
Mailing Address - Street 2:STE. 4
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-8230
Mailing Address - Country:US
Mailing Address - Phone:919-778-3898
Mailing Address - Fax:919-778-3896
Practice Address - Street 1:1913 N BERKELEY BLVD
Practice Address - Street 2:STE. 4
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-8230
Practice Address - Country:US
Practice Address - Phone:919-778-3898
Practice Address - Fax:919-778-3896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC078MCOtherBCBS
NC7211802Medicaid
NC7211802Medicaid
NC2336051Medicare PIN