Provider Demographics
NPI:1639251267
Name:PALMER, THOMAS DARWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DARWIN
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 1:1925 E APPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-4396
Mailing Address - Country:US
Mailing Address - Phone:231-777-2622
Mailing Address - Fax:231-777-4814
Practice Address - Street 1:1925 E APPLE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4396
Practice Address - Country:US
Practice Address - Phone:231-777-2622
Practice Address - Fax:231-777-4814
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002646111N00000X
AZ3172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MITP002646OtherPRIVATE INS. I.D.
MITP002646OtherBLUE CROSS BLUE SHIELD
MITP002646OtherPRIVATE INS. I.D.