Provider Demographics
NPI:1548579154
Name:PALAZZOLO, RAQUEL G (DC)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:G
Last Name:PALAZZOLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 W MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1537
Mailing Address - Country:US
Mailing Address - Phone:909-620-2777
Mailing Address - Fax:909-620-2811
Practice Address - Street 1:780 W MISSION BLVD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1537
Practice Address - Country:US
Practice Address - Phone:909-620-2777
Practice Address - Fax:909-620-2811
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31268111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health