Provider Demographics
NPI:1598721599
Name:NORMAN, DANIEL J (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:NORMAN
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 1:3831 PIPER STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4672
Mailing Address - Country:US
Mailing Address - Phone:907-563-3145
Mailing Address - Fax:907-561-0214
Practice Address - Street 1:3831 PIPER STREET
Practice Address - Street 2:SUITE 220
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4672
Practice Address - Country:US
Practice Address - Phone:907-563-3145
Practice Address - Fax:907-561-0214
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007427225100000X
AK2145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2525244Medicaid
AKPT0078Medicaid
AKK163029Medicare PIN