Provider Demographics
NPI:1033756838
Name:PALMER, LISA (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 E SHEA BLVD STE 261
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4687
Mailing Address - Country:US
Mailing Address - Phone:480-702-1360
Mailing Address - Fax:
Practice Address - Street 1:5040 E SHEA BLVD STE 261
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4687
Practice Address - Country:US
Practice Address - Phone:480-702-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor