Individual
MRS. PAULA JANE SORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T. # 3321
Contact information
Practice address
15093 E LIMESTONE RD, HARVEST, AL 35749-7219
(256) 520-0663
Mailing address
123 BRIDGE CREST DR, HARVEST, AL 35749-4500
(256) 520-0663
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3321
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3321
ALABAMA LICENSE NUMBER
AL
Enumeration date
03/20/2012
Last updated
06/05/2012
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