Provider Demographics
NPI:1326404823
Name:NORTON, JUSTIN D (HIS)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:D
Last Name:NORTON
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 32ND ST SE
Mailing Address - Street 2:#100
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7901
Mailing Address - Country:US
Mailing Address - Phone:616-828-4770
Mailing Address - Fax:517-827-4952
Practice Address - Street 1:2350 32ND ST SE
Practice Address - Street 2:#100
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-7901
Practice Address - Country:US
Practice Address - Phone:616-828-4770
Practice Address - Fax:517-827-4952
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501006699237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist