Healthcare Provider Details

I. General information

NPI: 1831147628
Provider Name (Legal Business Name): JAMES TED PALMER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 S BOULDER HWY STE B
HENDERSON NV
89015
US

IV. Provider business mailing address

537 S BOULDER HWY STE B
HENDERSON NV
89015
US

V. Phone/Fax

Practice location:
  • Phone: 702-565-6211
  • Fax: 866-311-8254
Mailing address:
  • Phone: 702-565-6211
  • Fax: 866-311-8254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB-456
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: