Provider Demographics
NPI:1831636570
Name:BPALM, INC.
Entity Type:Organization
Organization Name:BPALM, INC.
Other - Org Name:M1 MOVEMENT & THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:602-345-1984
Mailing Address - Street 1:1611 W WHISPERING WIND DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0649
Mailing Address - Country:US
Mailing Address - Phone:602-345-1984
Mailing Address - Fax:
Practice Address - Street 1:1611 W WHISPERING WIND DR
Practice Address - Street 2:SUITE 4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0649
Practice Address - Country:US
Practice Address - Phone:602-345-1984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11728261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy