Provider Demographics
NPI:1912054529
Name:PALMER, JOEL E (DC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:E
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 1:56 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:VERGENNES
Mailing Address - State:VT
Mailing Address - Zip Code:05491-1309
Mailing Address - Country:US
Mailing Address - Phone:802-877-3567
Mailing Address - Fax:802-877-3567
Practice Address - Street 1:56 GREEN ST
Practice Address - Street 2:
Practice Address - City:VERGENNES
Practice Address - State:VT
Practice Address - Zip Code:05491-1309
Practice Address - Country:US
Practice Address - Phone:802-877-3567
Practice Address - Fax:802-877-3567
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT035-18525OtherBCBS PROVIDER NUMBER
VTVN0302Medicare ID - Type Unspecified
VTU29455Medicare UPIN