Provider Demographics
NPI:1902983901
Name:PALMER CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:PALMER CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-760-8009
Mailing Address - Street 1:172 ANA DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1759
Mailing Address - Country:US
Mailing Address - Phone:256-760-8009
Mailing Address - Fax:256-760-8031
Practice Address - Street 1:172 ANA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1759
Practice Address - Country:US
Practice Address - Phone:256-760-8009
Practice Address - Fax:256-760-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU82662Medicare UPIN