Provider Demographics
NPI:1477892982
Name:NORRIS, JODI (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MCGHEE LN
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-9425
Mailing Address - Country:US
Mailing Address - Phone:740-243-3694
Mailing Address - Fax:
Practice Address - Street 1:230 MCGHEE LN
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-9425
Practice Address - Country:US
Practice Address - Phone:740-243-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA01347225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant