Provider Demographics
NPI:1518289602
Name:PALMER, THOMAS (LMT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2461
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-2461
Mailing Address - Country:US
Mailing Address - Phone:941-928-8878
Mailing Address - Fax:
Practice Address - Street 1:2055 WOOD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7903
Practice Address - Country:US
Practice Address - Phone:941-928-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA56892225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist