Provider Demographics
NPI:1457438798
Name:PALMER CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:PALMER CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:WOOD
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-369-1015
Mailing Address - Street 1:901 7TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALTAVISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24517-1603
Mailing Address - Country:US
Mailing Address - Phone:434-369-1015
Mailing Address - Fax:434-369-1017
Practice Address - Street 1:901 7TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-1603
Practice Address - Country:US
Practice Address - Phone:434-369-1015
Practice Address - Fax:434-369-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023195302OtherINDIVIDUAL NPI ADAM W. PALMER, D.C.
VA440426OtherANTHEM ALTAVISTA PALMER
VAC09400Medicare PIN
VA350000930Medicare ID - Type UnspecifiedDR. PALMER
VAU71859Medicare UPIN