MEDICARE: ANNE SORENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	A1982	MN

General Provider Information

NPI Number	:	1932573458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE SORENSON

Provider Business Mailing Address
First Line	:	3700 FOSS RD
Second Line	:	ST ANTOTHONY HEALTH CENTER, THERAPY DEPARTMENT
City	:	SAINT ANTHONY
State	:	MN
Zip	:	55421-4512
Country	:	US
Telephone Number	:	612-913-5317
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 FOSS RD
Second Line	:	SAINT ANTHONY HEALTH CENTER- THERAPY
City	:	SAINT ANTHONY
State	:	MN
Zip	:	55421-4512
Country	:	US
Telephone Number	:	612-913-5317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2015
Last Update Date	:	11/20/2015

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