Provider Demographics
NPI:1811395957
Name:SORENSEN, DIANNE (PT)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 NEW LEICESTER HWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1917
Mailing Address - Country:US
Mailing Address - Phone:828-258-8800
Mailing Address - Fax:
Practice Address - Street 1:149 NEW LEICESTER HWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1917
Practice Address - Country:US
Practice Address - Phone:828-225-3838
Practice Address - Fax:828-225-3839
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP9829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19A9QOtherBCBS