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General NPI Number Information
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NPI Number | 1407967201
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Entity Type | Individual
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Provider Name | ETAINE MADELINE NORRIS PT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20307-0003
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Country | US
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Telephone | 202-356-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 POOKS HILL RD #105-S
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City | BETHESDA
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State | MD
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Zip | 20814-2052
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Country | US
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Telephone | 202-213-4330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305202860
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License Number State | VA
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