Provider Demographics
NPI:1326502642
Name:NORTON, KENNETH CHAD (PTA)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:CHAD
Last Name:NORTON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-4028
Mailing Address - Country:US
Mailing Address - Phone:423-248-9595
Mailing Address - Fax:
Practice Address - Street 1:123 WESTERN PLAZA WAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2215
Practice Address - Country:US
Practice Address - Phone:423-623-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant