MEDICARE: ZACHARY NORRIS DPT

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	38258	FL

General Provider Information

NPI Number	:	1730833187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY NORRIS DPT

Provider Business Mailing Address
First Line	:	1010 N SWALLOW TAIL DR APT 405
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-4155
Country	:	US
Telephone Number	:	214-244-9635
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 DUNLAWTON AVE STE 4D
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-2918
Country	:	US
Telephone Number	:	386-671-2626
Fax Number	:

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

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	02/04/2022

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Directions to “ ZACHARY NORRIS DPT” Practice Location

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