Provider Demographics
NPI:1275235228
Name:SORENSON, KAITLYN (DC)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:
Last Name:SORENSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9809 CHERRY VALLEY AVE SE STE D
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9592
Mailing Address - Country:US
Mailing Address - Phone:616-706-7377
Mailing Address - Fax:
Practice Address - Street 1:9809 CHERRY VALLEY AVE SE STE D
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9592
Practice Address - Country:US
Practice Address - Phone:616-706-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor