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General NPI Number Information
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NPI Number | 1780537357
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Entity Type | Organization
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Legal Business Name | THE PALMS HEALTH CENTER
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 62 BRENDA ST
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City | GLEN CARBON
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State | IL
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Zip | 62034-1938
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Country | US
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Telephone | 618-917-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 62 BRENDA ST
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City | GLEN CARBON
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State | IL
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Zip | 62034-1938
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Country | US
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Telephone | 618-917-1003
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. RYAN G LOUCKS
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Credential | DC
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Telephone | 618-580-8619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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