Provider Demographics
NPI:1770352908
Name:SORENSON, WESTON MARK (DC)
Entity type:Individual
Prefix:DR
First Name:WESTON
Middle Name:MARK
Last Name:SORENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 E BAMBERGER DR
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-5504
Mailing Address - Country:US
Mailing Address - Phone:801-794-9494
Mailing Address - Fax:
Practice Address - Street 1:1042 E BAMBERGER DR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-5504
Practice Address - Country:US
Practice Address - Phone:801-794-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7644002-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor