Individual
REBECCA RAE SORENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
PO BOX PH, CHINLE, AZ 86503
(928) 674-7628
(928) 674-7707
Mailing address
PO BOX 4036, CHINLE, AZ 86503-4036
(218) 343-7684
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3041
OK
152W00000X
Optometrist
OPT.0004000
CO
Other
Enumeration date
03/17/2018
Last updated
06/27/2024
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