Provider Demographics
NPI:1679830202
Name:PALMER, BRUCE ALLEN JR
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ALLEN
Last Name:PALMER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 YOUNGSTOWN POLAND RD
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1058
Mailing Address - Country:US
Mailing Address - Phone:330-755-2147
Mailing Address - Fax:
Practice Address - Street 1:420 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1058
Practice Address - Country:US
Practice Address - Phone:330-755-2147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker