Provider Demographics
NPI:1588462006
Name:NORTON, TRISTAN NICHOLAS (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRISTAN
Middle Name:NICHOLAS
Last Name:NORTON
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 WOODS EDGE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7257
Mailing Address - Country:US
Mailing Address - Phone:760-814-0693
Mailing Address - Fax:
Practice Address - Street 1:818 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1116
Practice Address - Country:US
Practice Address - Phone:757-261-4475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist