1487859369 NPI number — REBECCA A. NORTON, OTR, PC

Table of content: (NPI 1487859369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487859369 NPI number — REBECCA A. NORTON, OTR, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REBECCA A. NORTON, OTR, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HANDWORKS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487859369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 762
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEFISH
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59937-0762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-862-8175
Provider Business Mailing Address Fax Number:
406-862-8176

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 SPOKANE AVE APT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEFISH
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59937-2729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-862-8175
Provider Business Practice Location Address Fax Number:
406-862-8176
Provider Enumeration Date:
06/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NORTON
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
406-862-8175

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  495 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0562054 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0349367 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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