Individual
MRS. KIM ANN SORGEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3000
Mailing address
339 DENNISON DR, O FALLON, IL 62269-3527
(618) 628-7898
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160001740
IL
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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