Provider Demographics
NPI:1598812067
Name:PALMER, TIMOTHY S (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:S
Last Name:PALMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PLEASANT PL
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3005
Mailing Address - Country:US
Mailing Address - Phone:302-328-2656
Mailing Address - Fax:302-328-5870
Practice Address - Street 1:1 PLEASANT PL
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3005
Practice Address - Country:US
Practice Address - Phone:302-328-2656
Practice Address - Fax:302-328-5870
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE561525Medicare ID - Type Unspecified