Healthcare Provider Details

I. General information

NPI: 1922910520
Provider Name (Legal Business Name): ELIZABETH PALMER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 JEFFERSON ST NE STE 102
ALBUQUERQUE NM
87109-3491
US

IV. Provider business mailing address

3926 S 13TH AVE
TUCSON AZ
85714-1334
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-2922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: