Provider Demographics
NPI:1922134824
Name:TERRY PALMER DC PC
Entity Type:Organization
Organization Name:TERRY PALMER DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-854-1455
Mailing Address - Street 1:81 W SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:MI
Mailing Address - Zip Code:49421-9702
Mailing Address - Country:US
Mailing Address - Phone:231-854-1455
Mailing Address - Fax:231-854-0299
Practice Address - Street 1:81 W SOUTH AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:MI
Practice Address - Zip Code:49421-9702
Practice Address - Country:US
Practice Address - Phone:231-854-1455
Practice Address - Fax:231-854-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDP007201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3281611Medicaid
MI3281611Medicaid
MIU70545Medicare UPIN