Provider Demographics
NPI:1902391246
Name:SORVIG, JOSHUA (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:SORVIG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17699 110TH ST SW
Mailing Address - Street 2:
Mailing Address - City:RED LAKE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56750-9341
Mailing Address - Country:US
Mailing Address - Phone:218-688-3399
Mailing Address - Fax:
Practice Address - Street 1:1420 9TH ST E STE 401
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3381
Practice Address - Country:US
Practice Address - Phone:701-364-2739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist