Provider Demographics
NPI:1801068549
Name:SORENSEN, ALISON A (DC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:A
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:A
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:66090 200TH ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:MN
Mailing Address - Zip Code:56009-5516
Mailing Address - Country:US
Mailing Address - Phone:507-383-1906
Mailing Address - Fax:
Practice Address - Street 1:1629 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-1868
Practice Address - Country:US
Practice Address - Phone:507-373-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350004091OtherMEDICARE PTAN