Provider Demographics
NPI:1831937796
Name:NORCROSS, GABRIEL (ATC, OTC)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:NORCROSS
Suffix:
Gender:M
Credentials:ATC, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8090 ADAIR LN APT 5509
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-5134
Mailing Address - Country:US
Mailing Address - Phone:706-599-7457
Mailing Address - Fax:
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1705
Practice Address - Country:US
Practice Address - Phone:404-355-0743
Practice Address - Fax:855-286-3226
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0037772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer