Provider Demographics
NPI:1578891255
Name:SORENSON CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:SORENSON CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:SORENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-946-9715
Mailing Address - Street 1:2209 W I 240 SERVICE RD STE 306
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-8252
Mailing Address - Country:US
Mailing Address - Phone:405-946-9715
Mailing Address - Fax:405-946-9756
Practice Address - Street 1:2209 W I 240 SERVICE RD STE 306
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-8252
Practice Address - Country:US
Practice Address - Phone:405-946-9715
Practice Address - Fax:405-946-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT80022Medicare UPIN
OK0DCFSMedicare PIN