Healthcare Provider Details

I. General information

NPI: 1457438798
Provider Name (Legal Business Name): PALMER CHIROPRACTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 7TH ST SUITE B
ALTAVISTA VA
24517-1603
US

IV. Provider business mailing address

901 7TH ST SUITE B
ALTAVISTA VA
24517-1603
US

V. Phone/Fax

Practice location:
  • Phone: 434-369-1015
  • Fax: 434-369-1017
Mailing address:
  • Phone: 434-369-1015
  • Fax: 434-369-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001965
License Number StateVA

VIII. Authorized Official

Name: DR. ADAM WOOD PALMER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 434-369-1015