Healthcare Provider Details

I. General information

NPI: 1316488133
Provider Name (Legal Business Name): JAMES PHILLIP PALMER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 12/23/2019
Certification Date: 12/23/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8805 NEW HIGHWAY 68 UNIT 1
TELLICO PLAINS TN
37385-3552
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
BIRMINGHAM AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 423-253-3300
  • Fax: 423-253-3947
Mailing address:
  • Phone: 717-839-2125
  • Fax: 717-565-1104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305211813
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4021
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007688
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11965
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: