Provider Demographics
NPI:1215029855
Name:NORTON, BRUCE E (PT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:E
Last Name:NORTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7861 E LEE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5022
Mailing Address - Country:US
Mailing Address - Phone:520-721-7076
Mailing Address - Fax:
Practice Address - Street 1:1120 S SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4910
Practice Address - Country:US
Practice Address - Phone:520-721-3822
Practice Address - Fax:520-747-8742
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ459166Medicaid