Provider Demographics
NPI:1417170226
Name:NORTON, MARTHA ANN (PT)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ANN
Last Name:NORTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20600 RIVER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72135-9387
Mailing Address - Country:US
Mailing Address - Phone:501-580-2222
Mailing Address - Fax:
Practice Address - Street 1:1600 RIVERFRONT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202
Practice Address - Country:US
Practice Address - Phone:501-663-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR129374721Medicaid