Individual
BEAU BRADLEY SORENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4612 PRAIRIE PKWY, CEDAR FALLS, IA 50613-7971
(319) 859-8139
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-5390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
118465
IA
363AS0400X
Surgical Physician Assistant
118465
IA
Other
Enumeration date
11/21/2022
Last updated
09/26/2023
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