Provider Demographics
NPI:1427063262
Name:PALMER, TAMARA LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LEIGH
Last Name:PALMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WATER ST
Mailing Address - Street 2:BLG #2
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3007
Mailing Address - Country:US
Mailing Address - Phone:508-478-2008
Mailing Address - Fax:
Practice Address - Street 1:114 WATER ST
Practice Address - Street 2:BLG #2
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3007
Practice Address - Country:US
Practice Address - Phone:508-478-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA02344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002344OtherTUFTS
MA351-299OtherHPHC
MAY39453OtherBCBS GROUP
MAY36633OtherBCBS
MAY4530301Medicare PIN