Provider Demographics
NPI:1366028417
Name:PALMERCARE CHIROPRACTIC COLLEYVILLE LLC
Entity Type:Organization
Organization Name:PALMERCARE CHIROPRACTIC COLLEYVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-421-2990
Mailing Address - Street 1:5604 COLLEYVILLE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6036
Mailing Address - Country:US
Mailing Address - Phone:703-421-2990
Mailing Address - Fax:703-421-2822
Practice Address - Street 1:5604 COLLEYVILLE BLVD STE C
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6036
Practice Address - Country:US
Practice Address - Phone:703-421-2990
Practice Address - Fax:703-421-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty