Provider Demographics
NPI:1669496212
Name:PALMER, JENNIFER A (RPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6814
Mailing Address - Country:US
Mailing Address - Phone:203-797-1500
Mailing Address - Fax:203-791-0495
Practice Address - Street 1:226 WHITE ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6814
Practice Address - Country:US
Practice Address - Phone:203-797-1500
Practice Address - Fax:203-791-0495
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist