Provider Demographics
NPI:1619494325
Name:NORMAN, WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:NORMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 VIRGIL AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IA
Mailing Address - Zip Code:52314-9569
Mailing Address - Country:US
Mailing Address - Phone:319-895-8655
Mailing Address - Fax:319-895-8651
Practice Address - Street 1:202 BLAIRS FERRY RD NE STE D
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-1616
Practice Address - Country:US
Practice Address - Phone:319-200-8004
Practice Address - Fax:319-200-8005
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ131822251X0800X
IA113914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic