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NPI Code Detail

MEDICARE: ERICA NORMAN PTA

MEDICARE: ERICA NORMAN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant4594TN

General Provider Information

NPI Number : 1689005076
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA NORMAN PTA
Provider Business Mailing Address
First Line : 101 JACKSON WALK PLZ
Second Line :
City : JACKSON
State : TN
Zip : 38301-3008
Country : US
Telephone Number : 731-427-7048
Fax Number : 731-660-8739
Provider Business Practice Location Address
First Line : 101 JACKSON WALK PLZ
Second Line :
City : JACKSON
State : TN
Zip : 38301-3008
Country : US
Telephone Number : 731-427-7048
Fax Number : 731-660-8739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2013
Last Update Date : 12/10/2013

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Directions to “ ERICA NORMAN PTA” Practice Location

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