Provider Demographics
NPI:1124100631
Name:PALMER, DAMIAN AARON (DC)
Entity type:Individual
Prefix:DR
First Name:DAMIAN
Middle Name:AARON
Last Name:PALMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WEST SOUTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:MI
Mailing Address - Zip Code:49421-9702
Mailing Address - Country:US
Mailing Address - Phone:231-854-1455
Mailing Address - Fax:231-854-0299
Practice Address - Street 1:81 W SOUTH AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:MI
Practice Address - Zip Code:49421-9702
Practice Address - Country:US
Practice Address - Phone:231-854-1455
Practice Address - Fax:231-854-0299
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDP007201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3281611Medicaid
MI3281611Medicaid
MIOM58060Medicare ID - Type Unspecified