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NPI Code Detail

MEDICARE: ANTHONY NORMAN III

MEDICARE: ANTHONY NORMAN III
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
1225100000XPhysical TherapistPT017158GA

General Provider Information

NPI Number : 1790529592
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY NORMAN III
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1825 ROCKBRIDGE RD STE 15A
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30087-3301
Country : US
Telephone Number : 470-977-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2024
Last Update Date : 05/18/2026

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Directions to “ ANTHONY NORMAN III ” Practice Location

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