Provider Demographics
NPI:1356126387
Name:PALMER, CARTER RYAN (BS)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:RYAN
Last Name:PALMER
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 OLD SALEM RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45315-9738
Mailing Address - Country:US
Mailing Address - Phone:937-266-9197
Mailing Address - Fax:
Practice Address - Street 1:135 TIMBERWIND LN
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-9763
Practice Address - Country:US
Practice Address - Phone:937-416-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker