Provider Demographics
NPI:1356938047
Name:PALMER, MAKAYLA SCOTT (DPT)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:SCOTT
Last Name:PALMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:J
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1369 HEADLAND AVE # 15A
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2819
Mailing Address - Country:US
Mailing Address - Phone:334-769-2003
Mailing Address - Fax:334-769-2004
Practice Address - Street 1:1369 HEADLAND AVE STE 15A
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2819
Practice Address - Country:US
Practice Address - Phone:334-769-2003
Practice Address - Fax:334-769-2004
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH10165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist