Provider Demographics
NPI:1558585356
Name:PALZER, GREGG N (PT, DC)
Entity Type:Individual
Prefix:MR
First Name:GREGG
Middle Name:N
Last Name:PALZER
Suffix:
Gender:M
Credentials:PT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32017 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9727
Mailing Address - Country:US
Mailing Address - Phone:541-223-2090
Mailing Address - Fax:
Practice Address - Street 1:32017 HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-9727
Practice Address - Country:US
Practice Address - Phone:541-223-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist