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General NPI Number Information
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NPI Number | 1073092375
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Entity Type | Individual
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Provider Name | PALMER LOR XIENG YANG D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 2345 RICE ST STE 128
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City | ROSEVILLE
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State | MN
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Zip | 55113-3720
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Country | US
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Telephone | 651-348-2338
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Fax | 855-792-3260
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Provider Business Mailing Address
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Address Line | 2353 RICE ST STE 112
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City | ROSEVILLE
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State | MN
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Zip | 55113-3721
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Country | US
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Telephone | 651-230-5526
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Fax | 855-792-3260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6530
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License Number State | MN
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