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General NPI Number Information
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NPI Number | 1780104554
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Entity Type | Organization
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Legal Business Name | A.K. MCCOY SORENSEN PLLC
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 9201 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85037-3332
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Country | US
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Telephone | 623-979-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 7021 W EMILE ZOLA AVE
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City | PEORIA
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State | AZ
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Zip | 85381-5074
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Country | US
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Telephone | 623-979-4554
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Fax | 602-783-1026
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Authorized Official
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Title or Position | OWNER
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Name | AMY MCCOY SORENSEN
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Credential |
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Telephone | 623-979-4554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | AZ
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