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General NPI Number Information
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NPI Number | 1720405533
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Entity Type | Individual
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Provider Name | ANDREW THOMAS SORRENTO D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2014
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE STE 400
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1313
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Country | US
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Telephone | 703-751-1008
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Fax | 703-751-1118
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Provider Business Mailing Address
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Address Line | 5252 LYNGATE CT STE 203
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City | BURKE
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State | VA
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Zip | 22015-1672
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Country | US
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Telephone | 703-239-2300
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Fax | 703-239-2301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104557181
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S03777
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License Number State | MD
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