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General NPI Number Information
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NPI Number | 1326491457
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Entity Type | Individual
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Provider Name | MARISSA PALMER D.C.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 13677 FOOTHILL BLVD STE P
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City | FONTANA
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State | CA
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Zip | 92335-0214
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Country | US
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Telephone | 909-766-5397
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Fax |
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Provider Business Mailing Address
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Address Line | 20687 AMAR RD STE 2
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City | WALNUT
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State | CA
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Zip | 91789-5045
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Country | US
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Telephone |
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Fax |
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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 | 33617
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License Number State | CA
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