Provider Demographics
NPI:1194457739
Name:PALMER, HAILEA (DC)
Entity Type:Individual
Prefix:
First Name:HAILEA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HAILEA
Other - Middle Name:SCOTT
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:14 COLUMBIA CIR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 COLUMBIA CIR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5152
Practice Address - Country:US
Practice Address - Phone:518-512-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor