Provider Demographics
NPI:1831147628
Name:PALMER, JAMES TED (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TED
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 1:537 S BOULDER HWY
Mailing Address - Street 2:STE B
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015
Mailing Address - Country:US
Mailing Address - Phone:702-565-6211
Mailing Address - Fax:866-311-8254
Practice Address - Street 1:537 S BOULDER HWY
Practice Address - Street 2:STE B
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015
Practice Address - Country:US
Practice Address - Phone:702-565-6211
Practice Address - Fax:866-311-8254
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU20821Medicare UPIN
NV37003Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #