MEDICARE: ASHLEY MARIE NORMAN

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
1	225100000X	Physical Therapist	035048	NY
2	225100000X	Physical Therapist	3157	NV

General Provider Information

NPI Number	:	1265789804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MARIE NORMAN

Provider Business Mailing Address
First Line	:	8505 ERIE RD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9703
Country	:	US
Telephone Number	:	716-549-1099
Fax Number	:

Provider Business Practice Location Address
First Line	:	8505 ERIE RD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9703
Country	:	US
Telephone Number	:	716-549-1099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	09/24/2015

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Directions to “ ASHLEY MARIE NORMAN ” Practice Location

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