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General NPI Number Information
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NPI Number | 1760480925
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Entity Type | Individual
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Provider Name | JONATHAN NORMAN GROUP D.C., R.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 24 ROUTE 134 SUITE 103
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3739
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Country | US
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Telephone | 508-394-4847
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Fax | 508-394-3638
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Provider Business Mailing Address
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Address Line | 24 ROUTE 134 SUITE 103
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3739
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Country | US
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Telephone | 508-394-4847
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Fax | 508-394-3638
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 807851
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3028
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License Number State | MA
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