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General NPI Number Information
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NPI Number | 1053050476
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Entity Type | Organization
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Legal Business Name | BRADEN SORENSEN OD PLLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 680 S GREEN VALLEY PKWY STE 120
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City | HENDERSON
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State | NV
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Zip | 89052-0438
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Country | US
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Telephone | 702-889-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 680 S GREEN VALLEY PKWY STE 120
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City | HENDERSON
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State | NV
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Zip | 89052-0438
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Country | US
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Telephone | 702-889-3937
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | BRADEN SORENSEN
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Credential | OD
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Telephone | 801-735-8896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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