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NPI Code Detail

MEDICARE: MRS. KAREN LORRAINE SORBO-GANGOLA PT

MEDICARE: MRS. KAREN LORRAINE SORBO-GANGOLA PT
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
1225100000XPhysical Therapist5501004317MI

General Provider Information

NPI Number : 1306805718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN LORRAINE SORBO-GANGOLA PT
Provider Business Mailing Address
First Line : 141 HAMPTON CIR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4103
Country : US
Telephone Number : 248-853-7555
Fax Number :
Provider Business Practice Location Address
First Line : 141 HAMPTON CIR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4103
Country : US
Telephone Number : 248-853-7555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 12/09/2020

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