Individual
NICOLAS SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
247 WEST 2230 NORTH #201, PROVO, UT 84604
(435) 590-9340
Mailing address
247 W 2230 N STE 201, PROVO, UT 84604-7579
(435) 590-9340
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6267488-4701
UT
Other
Enumeration date
09/25/2017
Last updated
07/21/2022
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