Provider Demographics
NPI:1699929570
Name:PALMER CHIROPRACTIC
Entity type:Organization
Organization Name:PALMER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-200-5995
Mailing Address - Street 1:3770 HIGHLAND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3252
Mailing Address - Country:US
Mailing Address - Phone:310-200-5995
Mailing Address - Fax:310-546-8775
Practice Address - Street 1:3770 HIGHLAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3252
Practice Address - Country:US
Practice Address - Phone:310-200-5995
Practice Address - Fax:310-546-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty