Provider Demographics
NPI:1316061724
Name:NORTON, TARA LUISA (PT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LUISA
Last Name:NORTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10211 ALM ST STE 212
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8221
Mailing Address - Country:US
Mailing Address - Phone:919-206-4868
Mailing Address - Fax:919-206-4860
Practice Address - Street 1:10211 ALM ST STE 212
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8221
Practice Address - Country:US
Practice Address - Phone:919-206-4868
Practice Address - Fax:919-206-4860
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27278225100000X
NCP11616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist