Provider Demographics
NPI:1871910562
Name:SORENSEN, NICHOLAS (PT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7269
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:123 BATTLEFIELD CROSSING CT
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5176
Practice Address - Country:US
Practice Address - Phone:706-861-8775
Practice Address - Fax:706-861-8785
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10778225100000X
TN11031225100000X
GA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist