Healthcare Provider Details

I. General information

NPI: 1407825888
Provider Name (Legal Business Name): ANNE P. SORRENTINO D.C., DACBSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE SORRENTINO HOOVER D.C., DACBSP

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 TYCO RD STE B
VIENNA VA
22182-2276
US

IV. Provider business mailing address

8502 TYCO RD STE B
VIENNA VA
22182-2276
US

V. Phone/Fax

Practice location:
  • Phone: 724-840-3443
  • Fax:
Mailing address:
  • Phone: 724-840-3443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC-003779L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104556993
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: