Provider Demographics
NPI:1558729525
Name:PALMER CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:PALMER CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, AP
Authorized Official - Phone:386-717-3029
Mailing Address - Street 1:1555 HOWELL BRANCH RD
Mailing Address - Street 2:STE B-2
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1170
Mailing Address - Country:US
Mailing Address - Phone:407-622-9090
Mailing Address - Fax:407-571-9570
Practice Address - Street 1:1555 HOWELL BRANCH RD
Practice Address - Street 2:STE B-2
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1170
Practice Address - Country:US
Practice Address - Phone:407-622-9090
Practice Address - Fax:407-571-9570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11619111N00000X
FLAP2928171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty