Provider Demographics
NPI:1174666218
Name:NORTON, SCOTT WAGNER (MSPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:WAGNER
Last Name:NORTON
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5203
Mailing Address - Country:US
Mailing Address - Phone:757-686-5742
Mailing Address - Fax:
Practice Address - Street 1:USS THEODORE ROOSEVELT CVN-71
Practice Address - Street 2:
Practice Address - City:FPO AE
Practice Address - State:VA
Practice Address - Zip Code:09599-2871
Practice Address - Country:US
Practice Address - Phone:757-443-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000005648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist