Provider Demographics
NPI:1730833187
Name:NORRIS, ZACHARY (DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:NORRIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N SWALLOW TAIL DR APT 405
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-4155
Mailing Address - Country:US
Mailing Address - Phone:214-244-9635
Mailing Address - Fax:
Practice Address - Street 1:1402 DUNLAWTON AVE STE 4D
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-2918
Practice Address - Country:US
Practice Address - Phone:386-671-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL38258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist