Provider Demographics
NPI:1144433798
Name:PALMER, JOHN DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
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 1:9316 BLOOMFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5936
Mailing Address - Country:US
Mailing Address - Phone:561-694-1803
Mailing Address - Fax:
Practice Address - Street 1:931 VILLAGE BLVD
Practice Address - Street 2:SUITE 903
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1803
Practice Address - Country:US
Practice Address - Phone:561-640-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor