Provider Demographics
NPI:1962798769
Name:PALMER, MARGARET SUZANNE (PT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:SUZANNE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:6351 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2676
Mailing Address - Country:US
Mailing Address - Phone:814-838-9191
Mailing Address - Fax:814-838-0583
Practice Address - Street 1:6351 W LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-2676
Practice Address - Country:US
Practice Address - Phone:814-838-9191
Practice Address - Fax:814-838-0583
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist