Provider Demographics
NPI:1881854644
Name:PALMER, RICHARD MARLEY (DC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MARLEY
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 1:1325 E THOUSAND OAKS BLVD
Mailing Address - Street 2:104
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2822
Mailing Address - Country:US
Mailing Address - Phone:805-371-6148
Mailing Address - Fax:805-371-6148
Practice Address - Street 1:1325 E THOUSAND OAKS BLVD
Practice Address - Street 2:104
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2822
Practice Address - Country:US
Practice Address - Phone:805-371-6144
Practice Address - Fax:805-371-6148
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0207350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor