Provider Demographics
NPI:1568534550
Name:HART, NORMAN GREG (PT)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:GREG
Last Name:HART
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 1:3901 WALNUT BLVD STE A2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2417
Mailing Address - Country:US
Mailing Address - Phone:925-516-1949
Mailing Address - Fax:925-516-1864
Practice Address - Street 1:3901 WALNUT BLVD STE A2
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2417
Practice Address - Country:US
Practice Address - Phone:925-516-1949
Practice Address - Fax:925-516-1864
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist