Healthcare Provider Details

I. General information

NPI: 1558729525
Provider Name (Legal Business Name): PALMER CHIROPRACTIC AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 HOWELL BRANCH RD STE B-2
WINTER PARK FL
32789-1170
US

IV. Provider business mailing address

1555 HOWELL BRANCH RD STE B-2
WINTER PARK FL
32789-1170
US

V. Phone/Fax

Practice location:
  • Phone: 407-622-9090
  • Fax: 407-571-9570
Mailing address:
  • Phone: 407-622-9090
  • Fax: 407-571-9570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11619
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2928
License Number StateFL

VIII. Authorized Official

Name: DR. WILLIAM PALMER
Title or Position: OWNER/MANAGER
Credential: DC, AP
Phone: 386-717-3029