Individual
PAULA SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2626 W MAIN ST, SUITE 4, RAPID CITY, SD 57702-2497
(605) 399-3811
(605) 399-3845
Mailing address
2626 W MAIN ST, SUITE 4, RAPID CITY, SD 57702-2497
(605) 399-3811
(605) 399-3845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
517
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9200072
—
SD
01
—
S41393
MEDICARE PROVIDER NUMBER
SD
Enumeration date
08/23/2006
Last updated
01/16/2013
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